Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $1,862.09 / $5,623.41	Facility		$151.36	$1,862.09	$5,623.41
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,096.48 / $3,311.31 / $6,760.83	Facility	50	$1,096.48	$3,311.31	$6,760.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $251.19 / $1,096.48	Professional		$104.71	$251.19	$1,096.48
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $478.63 / $478.63 / $1,548.82	Professional	22	$478.63	$478.63	$1,548.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $380.19 / $1,202.26	Professional	50	$158.49	$380.19	$1,202.26
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $36.31 / $36.31 / $37.15	Professional	53	$36.31	$36.31	$37.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $141.25 / $316.23	Professional		$97.72	$141.25	$316.23
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $141.25 / $223.87 / $426.58	Professional	50	$141.25	$223.87	$426.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,995.26 / $4,265.80 / $8,317.64	Facility		$1,995.26	$4,265.80	$8,317.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $102.33 / $213.80	Professional		$81.28	$102.33	$213.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $154.88 / $323.59	Professional	50	$123.03	$154.88	$323.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $125.89 / $147.91	Facility		$102.33	$125.89	$147.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $281.84 / $316.23	Professional		$218.78	$281.84	$316.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,454.71 / $2,454.71	Facility		$2,454.71	$2,454.71	$2,454.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $239.88 / $501.19	Professional		$114.82	$239.88	$501.19
United Facility/Professional Facility Modifier Low / Median / High Price $741.31 / $2,818.38 / $4,466.84	Facility		$741.31	$2,818.38	$4,466.84
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $194.98 / $416.87	Professional		$100.00	$194.98	$416.87