Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,173.00 / $5,096.22 / $12,169.65	Facility		$1,173.00	$5,096.22	$12,169.65
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $9,664.75 / $9,664.75 / $9,664.75	Facility	50	$9,664.75	$9,664.75	$9,664.75
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $101.53 / $101.53 / $166.24	Facility	53	$101.53	$101.53	$166.24
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $380.75 / $380.75 / $623.38	Facility	54	$380.75	$380.75	$623.38
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $76.15 / $76.15 / $124.68	Facility	55	$76.15	$76.15	$124.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $492.24 / $586.51 / $1,035.90	Professional		$492.24	$586.51	$1,035.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $253.84 / $277.54 / $342.68	Professional	52	$253.84	$277.54	$342.68
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $380.75 / $416.31 / $570.92	Professional	54	$380.75	$416.31	$570.92
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $76.15 / $83.26 / $114.19	Professional	55	$76.15	$83.26	$114.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $320.18 / $491.82 / $737.73	Professional		$320.18	$491.82	$737.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,278.00 / $6,133.00 / $8,240.00	Facility		$3,278.00	$6,133.00	$8,240.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $612.91 / $766.16 / $1,032.17	Professional		$612.91	$766.16	$1,032.17
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $919.39 / $1,149.24 / $1,548.25	Professional	50	$919.39	$1,149.24	$1,548.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $491.82 / $639.37 / $959.06	Facility		$491.82	$639.37	$959.06
CareSource Facility/Professional Professional Modifier Low / Median / High Price $491.82 / $565.59 / $737.73	Professional		$491.82	$565.59	$737.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,046.66 / $6,132.62 / $6,133.00	Facility		$1,046.66	$6,132.62	$6,133.00
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $120.35 / $120.35 / $120.35	Facility	53	$120.35	$120.35	$120.35
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $421.21 / $421.21 / $421.21	Facility	54	$421.21	$421.21	$421.21
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $90.26 / $90.26 / $90.26	Facility	55	$90.26	$90.26	$90.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $539.27 / $749.56 / $1,366.87	Professional		$539.27	$749.56	$1,366.87
United Facility/Professional Facility Modifier Low / Median / High Price $1,076.00 / $5,995.00 / $10,413.00	Facility		$1,076.00	$5,995.00	$10,413.00
United Facility/Professional Professional Modifier Low / Median / High Price $520.64 / $668.10 / $1,139.00	Professional		$520.64	$668.10	$1,139.00