Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.31 / $2,747.00 / $8,229.00	Facility		$208.31	$2,747.00	$8,229.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,200.00 / $7,313.77 / $7,823.30	Facility	50	$2,200.00	$7,313.77	$7,823.30
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $76.29 / $181.30 / $452.00	Facility	52	$76.29	$181.30	$452.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $30.51 / $72.52 / $180.80	Facility	53	$30.51	$72.52	$180.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $153.75 / $347.39 / $743.06	Professional		$153.75	$347.39	$743.06
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $220.07 / $220.07 / $220.07	Professional	50	$220.07	$220.07	$220.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,421.00 / $3,511.00 / $11,593.00	Facility		$1,421.00	$3,511.00	$11,593.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.08 / $351.48 / $653.96	Professional		$140.08	$351.48	$653.96
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $210.12 / $527.22 / $980.95	Professional	50	$210.12	$527.22	$980.95
CareSource Facility/Professional Facility Modifier Low / Median / High Price $143.25 / $200.55 / $236.36	Facility		$143.25	$200.55	$236.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $186.23 / $379.07 / $507.63	Professional		$186.23	$379.07	$507.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.40 / $263.58 / $263.58	Facility		$151.40	$263.58	$263.58
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $210.86 / $210.86 / $210.86	Facility	52	$210.86	$210.86	$210.86
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $52.72 / $52.72 / $52.72	Facility	53	$52.72	$52.72	$52.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.85 / $406.14 / $879.84	Professional		$160.85	$406.14	$879.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
United Facility/Professional Facility Modifier Low / Median / High Price $599.00 / $3,086.00 / $6,295.00	Facility		$599.00	$3,086.00	$6,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $415.34 / $626.48 / $862.53	Professional		$415.34	$626.48	$862.53