Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $760.78 / $2,070.09 / $9,757.32	Facility		$760.78	$2,070.09	$9,757.32
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $551.39 / $570.59 / $764.07	Facility	54	$551.39	$570.59	$764.07
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $110.28 / $114.12 / $152.81	Facility	55	$110.28	$114.12	$152.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $739.26 / $912.60 / $1,249.50	Professional		$739.26	$912.60	$1,249.50
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $523.58 / $570.59 / $764.07	Professional	54	$523.58	$570.59	$764.07
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $104.72 / $114.12 / $152.81	Professional	55	$104.72	$114.12	$152.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $471.45 / $683.57 / $893.37	Professional		$471.45	$683.57	$893.37
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,653.00 / $4,800.00 / $8,934.00	Facility		$2,653.00	$4,800.00	$8,934.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $709.63 / $859.91 / $1,224.09	Professional		$709.63	$859.91	$1,224.09
Anthem BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $2,000.00 / $2,000.00 / $2,000.00	Professional	54	$2,000.00	$2,000.00	$2,000.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $668.35 / $735.19 / $1,069.35	Facility		$668.35	$735.19	$1,069.35
CareSource Facility/Professional Professional Modifier Low / Median / High Price $668.35 / $741.09 / $1,069.35	Professional		$668.35	$741.09	$1,069.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $826.04 / $883.97 / $5,217.00	Facility		$826.04	$883.97	$5,217.00
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $577.02 / $577.02 / $577.02	Facility	54	$577.02	$577.02	$577.02
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $123.65 / $123.65 / $123.65	Facility	55	$123.65	$123.65	$123.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $638.84 / $1,140.28 / $2,213.17	Professional		$638.84	$1,140.28	$2,213.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $582.41	Professional		$32.34	$32.34	$582.41
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 $713.91 / $987.54 / $1,463.52	Professional		$713.91	$987.54	$1,463.52