Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $594.34 / $703.20 / $3,740.00	Facility		$594.34	$703.20	$3,740.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $445.76 / $478.06 / $527.40	Facility	54	$445.76	$478.06	$527.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $561.70 / $647.53 / $811.30	Professional		$561.70	$647.53	$811.30
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $446.31 / $511.93 / $607.10	Professional	54	$446.31	$511.93	$607.10
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $89.26 / $102.39 / $121.42	Professional	55	$89.26	$102.39	$121.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $615.48 / $615.48 / $615.48	Professional		$615.48	$615.48	$615.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,010.00 / $2,045.00 / $2,978.00	Facility		$1,010.00	$2,045.00	$2,978.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $437.48 / $530.13 / $802.92	Professional		$437.48	$530.13	$802.92
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $656.22 / $795.19 / $1,204.38	Professional	50	$656.22	$795.19	$1,204.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $539.21 / $734.82 / $864.50	Facility		$539.21	$734.82	$864.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $601.63 / $756.43 / $1,215.70	Professional		$601.63	$756.43	$1,215.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $500.74 / $540.16 / $994.17	Facility		$500.74	$540.16	$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 $517.79 / $696.92 / $2,801.72	Professional		$517.79	$696.92	$2,801.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $346.39	Professional		$32.34	$32.34	$346.39
United Facility/Professional Facility Modifier Low / Median / High Price $523.00 / $1,450.00 / $5,301.00	Facility		$523.00	$1,450.00	$5,301.00
United Facility/Professional Professional Modifier Low / Median / High Price $552.41 / $713.41 / $1,354.51	Professional		$552.41	$713.41	$1,354.51