Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.79 / $1,760.00 / $5,389.00	Facility		$124.79	$1,760.00	$5,389.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,022.50 / $2,102.98 / $5,283.00	Facility	50	$1,022.50	$2,102.98	$5,283.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.90 / $166.88 / $532.38	Professional		$96.90	$166.88	$532.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $148.53 / $248.56 / $937.63	Professional	50	$148.53	$248.56	$937.63
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.74 / $269.74 / $269.74	Professional		$269.74	$269.74	$269.74
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $187.45 / $229.07 / $229.07	Professional	50	$187.45	$229.07	$229.07
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $821.00 / $1,963.00 / $4,852.00	Facility		$821.00	$1,963.00	$4,852.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.42 / $121.19 / $201.56	Professional		$95.42	$121.19	$201.56
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $143.13 / $182.44 / $302.33	Professional	50	$143.13	$182.44	$302.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.18 / $207.49 / $368.98	Professional		$116.18	$207.49	$368.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.93 / $220.72 / $1,775.00	Facility		$103.93	$220.72	$1,775.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,709.43 / $2,376.50 / $2,441.05	Facility	50	$1,709.43	$2,376.50	$2,441.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $195.61 / $340.65 / $3,500.00	Professional		$195.61	$340.65	$3,500.00
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $263.43 / $263.43 / $263.43	Professional	50	$263.43	$263.43	$263.43
United Facility/Professional Facility Modifier Low / Median / High Price $899.00 / $1,632.00 / $2,675.00	Facility		$899.00	$1,632.00	$2,675.00
United Facility/Professional Professional Modifier Low / Median / High Price $176.05 / $291.83 / $474.37	Professional		$176.05	$291.83	$474.37