Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $562.01 / $881.63 / $5,634.00	Facility		$562.01	$881.63	$5,634.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $421.51 / $485.65 / $792.70	Facility	54	$421.51	$485.65	$792.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $562.01 / $647.53 / $766.64	Professional		$562.01	$647.53	$766.64
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $421.51 / $485.65 / $574.98	Professional	54	$421.51	$485.65	$574.98
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $84.30 / $97.13 / $115.00	Professional	55	$84.30	$97.13	$115.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,682.00 / $3,840.00 / $7,747.00	Facility		$1,682.00	$3,840.00	$7,747.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $514.00 / $642.50 / $865.57	Professional		$514.00	$642.50	$865.57
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $771.00 / $963.75 / $1,298.35	Professional	50	$771.00	$963.75	$1,298.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $546.37 / $731.46 / $1,239.52	Facility		$546.37	$731.46	$1,239.52
CareSource Facility/Professional Professional Modifier Low / Median / High Price $625.40 / $750.48 / $1,125.72	Professional		$625.40	$750.48	$1,125.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $326.00 / $422.00 / $994.17	Facility		$326.00	$422.00	$994.17
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $695.92 / $695.92 / $695.92	Facility	54	$695.92	$695.92	$695.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $513.16 / $692.26 / $1,108.44	Professional		$513.16	$692.26	$1,108.44
United Facility/Professional Facility Modifier Low / Median / High Price $629.00 / $3,817.00 / $5,490.00	Facility		$629.00	$3,817.00	$5,490.00
United Facility/Professional Professional Modifier Low / Median / High Price $554.16 / $735.53 / $1,364.47	Professional		$554.16	$735.53	$1,364.47