Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $794.33 / $2,818.38	Facility		$338.84	$794.33	$2,818.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $371.54 / $588.84	Professional		$288.40	$371.54	$588.84
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $436.52 / $478.63 / $645.65	Professional	50	$436.52	$478.63	$645.65
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $218.78 / $218.78 / $338.84	Professional	54	$218.78	$218.78	$338.84
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $44.67 / $44.67 / $44.67	Professional	55	$44.67	$44.67	$44.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $245.47 / $288.40 / $436.52	Professional		$245.47	$288.40	$436.52
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $295.12 / $389.05	Professional	50	$295.12	$295.12	$389.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $2,398.83 / $4,365.16	Facility		$1,412.54	$2,398.83	$4,365.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $257.04 / $416.87	Professional		$218.78	$257.04	$416.87
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $331.13 / $389.05 / $616.60	Professional	50	$331.13	$389.05	$616.60
CareSource Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $371.54 / $416.87	Facility		$275.42	$371.54	$416.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $346.74 / $446.68	Professional		$295.12	$346.74	$446.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $512.86 / $512.86 / $1,862.09	Facility		$512.86	$512.86	$1,862.09
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 $257.04 / $389.05 / $1,548.82	Professional		$257.04	$389.05	$1,548.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $144.54	Professional		$32.36	$33.11	$144.54
United Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $954.99 / $3,388.44	Facility		$389.05	$954.99	$3,388.44
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $316.23 / $562.34	Professional		$251.19	$316.23	$562.34