Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $303.62 / $624.67 / $2,277.38	Facility		$303.62	$624.67	$2,277.38
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $202.45 / $236.42 / $253.50	Facility	54	$202.45	$236.42	$253.50
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $40.49 / $47.28 / $50.70	Facility	55	$40.49	$47.28	$50.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.14 / $327.80 / $503.95	Professional		$269.14	$327.80	$503.95
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $428.27 / $458.48 / $565.59	Professional	50	$428.27	$458.48	$565.59
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $217.84 / $247.11 / $295.13	Professional	54	$217.84	$247.11	$295.13
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $43.57 / $49.42 / $59.03	Professional	55	$43.57	$49.42	$59.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $226.13 / $273.83 / $412.24	Professional		$226.13	$273.83	$412.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,215.00 / $2,292.00 / $4,059.00	Facility		$1,215.00	$2,292.00	$4,059.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.97 / $251.74 / $396.86	Professional		$213.97	$251.74	$396.86
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $320.95 / $377.61 / $601.23	Professional	50	$320.95	$377.61	$601.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $276.02 / $303.62 / $413.26	Facility		$276.02	$303.62	$413.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $294.45 / $323.91 / $471.14	Professional		$294.45	$323.91	$471.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $219.01 / $320.77 / $507.88	Facility		$219.01	$320.77	$507.88
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $355.52 / $355.52 / $355.52	Facility	54	$355.52	$355.52	$355.52
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $76.18 / $76.18 / $76.18	Facility	55	$76.18	$76.18	$76.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $256.93 / $347.47 / $1,440.60	Professional		$256.93	$347.47	$1,440.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $192.76	Professional		$32.34	$32.34	$192.76
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 $255.81 / $328.90 / $528.11	Professional		$255.81	$328.90	$528.11