Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $462.42 / $3,120.00 / $13,177.00	Facility		$462.42	$3,120.00	$13,177.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,034.00 / $4,819.50 / $32,753.00	Facility	50	$3,034.00	$4,819.50	$32,753.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $290.98 / $835.74 / $2,056.40	Professional		$290.98	$835.74	$2,056.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $379.02 / $1,422.77 / $6,015.33	Professional	50	$379.02	$1,422.77	$6,015.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $121.78 / $209.54 / $585.77	Professional		$121.78	$209.54	$585.77
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $246.84 / $274.48 / $564.85	Professional	50	$246.84	$274.48	$564.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,224.00 / $4,490.00 / $11,459.00	Facility		$2,224.00	$4,490.00	$11,459.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $350.60 / $690.66 / $2,503.90	Professional		$350.60	$690.66	$2,503.90
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $525.90 / $1,026.54 / $3,755.85	Professional	50	$525.90	$1,026.54	$3,755.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $8,519.00 / $17,526.00 / $29,291.00	Facility		$8,519.00	$17,526.00	$29,291.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $343.90 / $801.28 / $2,982.83	Professional		$343.90	$801.28	$2,982.83
Medica Facility/Professional Facility Modifier Low / Median / High Price $354.00 / $1,287.13 / $3,425.16	Facility		$354.00	$1,287.13	$3,425.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $1,560.15 / $3,131.13 / $11,617.10	Professional		$1,560.15	$3,131.13	$11,617.10
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $2,128.94 / $2,128.94 / $2,128.94	Professional		$2,128.94	$2,128.94	$2,128.94
United Facility/Professional Facility Modifier Low / Median / High Price $245.00 / $875.00 / $1,795.00	Facility		$245.00	$875.00	$1,795.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,560.15 / $2,389.10 / $4,211.64	Professional		$1,560.15	$2,389.10	$4,211.64