Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $220.20 / $543.00 / $5,634.00	Facility		$220.20	$543.00	$5,634.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,054.48 / $2,054.48 / $2,054.48	Facility	50	$2,054.48	$2,054.48	$2,054.48
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $165.15 / $209.61 / $338.50	Facility	54	$165.15	$209.61	$338.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $220.20 / $279.48 / $494.68	Professional		$220.20	$279.48	$494.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $481.37 / $921.00 / $921.00	Professional	50	$481.37	$921.00	$921.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $165.15 / $209.61 / $248.20	Professional	54	$165.15	$209.61	$248.20
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $33.03 / $41.92 / $49.64	Professional	55	$33.03	$41.92	$49.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $212.78 / $212.78 / $347.18	Professional		$212.78	$212.78	$347.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $856.00 / $4,320.00 / $8,230.00	Facility		$856.00	$4,320.00	$8,230.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $259.10 / $382.68 / $562.99	Professional		$259.10	$382.68	$562.99
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $388.65 / $574.02 / $844.49	Professional	50	$388.65	$574.02	$844.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $212.78 / $284.87 / $494.72	Facility		$212.78	$284.87	$494.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $267.06 / $320.47 / $480.71	Professional		$267.06	$320.47	$480.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $223.28 / $356.73 / $450.00	Facility		$223.28	$356.73	$450.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $271.12 / $271.12 / $271.12	Facility	54	$271.12	$271.12	$271.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $243.43 / $376.21 / $608.79	Professional		$243.43	$376.21	$608.79
United Facility/Professional Facility Modifier Low / Median / High Price $462.00 / $2,811.00 / $4,271.00	Facility		$462.00	$2,811.00	$4,271.00
United Facility/Professional Professional Modifier Low / Median / High Price $281.64 / $354.94 / $624.39	Professional		$281.64	$354.94	$624.39