Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.73 / $444.89 / $5,320.00	Facility		$210.73	$444.89	$5,320.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $788.58 / $788.58 / $788.58	Facility	50	$788.58	$788.58	$788.58
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $152.59 / $180.21 / $295.08	Facility	54	$152.59	$180.21	$295.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.73 / $261.81 / $393.45	Professional		$210.73	$261.81	$393.45
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $641.51 / $1,038.23 / $1,038.23	Professional	50	$641.51	$1,038.23	$1,038.23
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $153.19 / $185.94 / $244.79	Professional	54	$153.19	$185.94	$244.79
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $30.64 / $36.67 / $48.96	Professional	55	$30.64	$36.67	$48.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $185.94 / $218.44 / $305.82	Professional		$185.94	$218.44	$305.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $260.60 / $260.60 / $327.66	Professional	50	$260.60	$260.60	$327.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,013.00 / $8,584.00 / $11,253.00	Facility		$3,013.00	$8,584.00	$11,253.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.28 / $263.87 / $432.70	Professional		$224.28	$263.87	$432.70
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $336.43 / $395.80 / $649.04	Professional	50	$336.43	$395.80	$649.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $184.96 / $203.46 / $276.94	Facility		$184.96	$203.46	$276.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $218.44 / $240.28 / $349.50	Professional		$218.44	$240.28	$349.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $142.33 / $340.33 / $341.39	Facility		$142.33	$340.33	$341.39
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $238.23 / $238.23 / $238.23	Facility	54	$238.23	$238.23	$238.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $203.04 / $339.91 / $949.49	Professional		$203.04	$339.91	$949.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $232.71	Professional		$32.34	$32.34	$232.71
United Facility/Professional Facility Modifier Low / Median / High Price $391.00 / $950.00 / $3,394.00	Facility		$391.00	$950.00	$3,394.00
United Facility/Professional Professional Modifier Low / Median / High Price $219.47 / $309.60 / $490.54	Professional		$219.47	$309.60	$490.54