Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $130.02 / $2,224.21 / $5,740.74	Facility		$130.02	$2,224.21	$5,740.74
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,236.00 / $3,296.48 / $6,796.62	Facility	50	$1,236.00	$3,296.48	$6,796.62
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.80 / $46.06 / $487.23	Facility	53	$20.80	$46.06	$487.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.46 / $230.28 / $790.50	Professional		$97.46	$230.28	$790.50
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.52 / $141.52 / $191.19	Professional	22	$141.52	$141.52	$191.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $177.66 / $522.61 / $1,402.63	Professional	50	$177.66	$522.61	$1,402.63
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $19.60 / $36.17 / $57.57	Professional	53	$19.60	$36.17	$57.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $94.72 / $152.76 / $221.22	Professional		$94.72	$152.76	$221.22
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $152.77 / $198.90 / $330.37	Professional	50	$152.77	$198.90	$330.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,399.00 / $3,677.00 / $5,445.00	Facility		$1,399.00	$3,677.00	$5,445.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.93 / $102.74 / $154.11	Professional		$79.93	$102.74	$154.11
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $119.89 / $154.11 / $231.16	Professional	50	$119.89	$154.11	$231.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $101.84 / $136.34 / $206.84	Facility		$101.84	$136.34	$206.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $220.24 / $264.29 / $346.88	Professional		$220.24	$264.29	$346.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $759.27 / $2,436.00 / $2,436.15	Facility		$759.27	$2,436.00	$2,436.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.10 / $229.09 / $466.96	Professional		$113.10	$229.09	$466.96
United Facility/Professional Facility Modifier Low / Median / High Price $1,638.00 / $3,267.00 / $4,271.00	Facility		$1,638.00	$3,267.00	$4,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $194.30 / $267.17 / $481.05	Professional		$194.30	$267.17	$481.05