Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $787.00 / $860.00 / $8,229.00	Facility		$787.00	$860.00	$8,229.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $604.58 / $614.42 / $663.88	Facility	54	$604.58	$614.42	$663.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $656.25 / $821.35 / $1,052.74	Professional		$656.25	$821.35	$1,052.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,088.00 / $3,889.00 / $8,766.00	Facility		$2,088.00	$3,889.00	$8,766.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $553.30 / $669.60 / $1,034.20	Professional		$553.30	$669.60	$1,034.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $733.46 / $1,025.95 / $1,172.51	Facility		$733.46	$1,025.95	$1,172.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $732.82 / $1,025.95 / $1,465.64	Professional		$732.82	$1,025.95	$1,465.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $710.84 / $925.34 / $1,322.53	Facility		$710.84	$925.34	$1,322.53
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $647.74 / $647.74 / $647.74	Facility	54	$647.74	$647.74	$647.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $652.94 / $868.29 / $1,556.24	Professional		$652.94	$868.29	$1,556.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $432.66	Professional		$32.34	$32.34	$432.66
United Facility/Professional Facility Modifier Low / Median / High Price $599.00 / $2,723.00 / $6,295.00	Facility		$599.00	$2,723.00	$6,295.00
United Facility/Professional Professional Modifier Low / Median / High Price $628.84 / $832.50 / $1,269.85	Professional		$628.84	$832.50	$1,269.85