Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $787.00 / $988.00 / $3,740.00	Facility		$787.00	$988.00	$3,740.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $598.61 / $624.14 / $655.85	Facility	54	$598.61	$624.14	$655.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $636.28 / $832.19 / $1,140.23	Professional		$636.28	$832.19	$1,140.23
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $115.58 / $125.47 / $152.16	Professional	55	$115.58	$125.47	$152.16
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,041.00 / $2,045.00 / $2,978.00	Facility		$1,041.00	$2,045.00	$2,978.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $545.83 / $660.40 / $1,071.90	Professional		$545.83	$660.40	$1,071.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $726.39 / $1,015.83 / $1,160.94	Facility		$726.39	$1,015.83	$1,160.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $709.26 / $1,015.83 / $1,451.18	Professional		$709.26	$1,015.83	$1,451.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $722.09 / $914.91 / $2,280.98	Facility		$722.09	$914.91	$2,280.98
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $640.44 / $640.44 / $640.44	Facility	54	$640.44	$640.44	$640.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $635.21 / $864.81 / $1,503.01	Professional		$635.21	$864.81	$1,503.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $491.28	Professional		$32.34	$32.34	$491.28
United Facility/Professional Facility Modifier Low / Median / High Price $599.00 / $2,723.00 / $6,295.00	Facility		$599.00	$2,723.00	$6,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $622.84 / $825.60 / $1,277.93	Professional		$622.84	$825.60	$1,277.93