Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $363.08 / $724.44 / $4,897.79	Facility		$363.08	$724.44	$4,897.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $398.11 / $794.33	Professional		$295.12	$398.11	$794.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $426.58 / $616.60 / $3,801.89	Professional	50	$426.58	$616.60	$3,801.89
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $234.42 / $338.84 / $912.01	Professional	54	$234.42	$338.84	$912.01
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $63.10 / $63.10 / $389.05	Professional	55	$63.10	$63.10	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $281.84 / $316.23	Professional		$245.47	$281.84	$316.23
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $588.84 / $588.84 / $588.84	Professional	50	$588.84	$588.84	$588.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,698.24 / $4,365.16 / $8,317.64	Facility		$1,698.24	$4,365.16	$8,317.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $295.12 / $436.52	Professional		$234.42	$295.12	$436.52
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $346.74 / $446.68 / $645.65	Professional	50	$346.74	$446.68	$645.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $302.00 / $389.05	Facility		$223.87	$302.00	$389.05
CareSource Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $323.59 / $389.05	Professional		$302.00	$323.59	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $478.63 / $1,698.24 / $1,698.24	Facility		$478.63	$1,698.24	$1,698.24
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $354.81 / $354.81 / $354.81	Facility	54	$354.81	$354.81	$354.81
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $75.86 / $75.86 / $75.86	Facility	55	$75.86	$75.86	$75.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $331.13 / $537.03	Professional		$239.88	$331.13	$537.03
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $2,818.38 / $4,265.80	Facility		$457.09	$2,818.38	$4,265.80
United Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $338.84 / $562.34	Professional		$263.03	$338.84	$562.34