Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $580.29 / $2,779.52 / $9,757.32	Facility		$580.29	$2,779.52	$9,757.32
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $107.24 / $111.02 / $160.76	Facility	53	$107.24	$111.02	$160.76
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $402.15 / $416.31 / $602.85	Facility	54	$402.15	$416.31	$602.85
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $80.43 / $120.57 / $4,687.22	Facility	55	$80.43	$120.57	$4,687.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.49 / $724.47 / $5,345.60	Professional		$97.49	$724.47	$5,345.60
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $254.64 / $288.63 / $381.95	Professional	52	$254.64	$288.63	$381.95
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $381.95 / $432.95 / $572.92	Professional	54	$381.95	$432.95	$572.92
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $76.39 / $86.59 / $114.59	Professional	55	$76.39	$86.59	$114.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $324.62 / $491.82 / $688.55	Professional		$324.62	$491.82	$688.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,487.00 / $4,604.00 / $8,913.00	Facility		$2,487.00	$4,604.00	$8,913.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $562.91 / $672.46 / $1,026.80	Professional		$562.91	$672.46	$1,026.80
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $844.36 / $1,008.69 / $1,540.20	Professional	50	$844.36	$1,008.69	$1,540.20
Anthem BCBS Facility/Professional Professional Modifier 54 Low / Median / High Price $1,900.00 / $1,900.00 / $1,900.00	Professional	54	$1,900.00	$1,900.00	$1,900.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $487.46 / $536.21 / $779.94	Facility		$487.46	$536.21	$779.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $487.46 / $536.21 / $779.94	Professional		$487.46	$536.21	$779.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.32 / $697.45 / $5,217.00	Facility		$602.32	$697.45	$5,217.00
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 $490.78 / $851.35 / $1,593.80	Professional		$490.78	$851.35	$1,593.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $424.10	Professional		$32.34	$32.34	$424.10
United Facility/Professional Facility Modifier Low / Median / High Price $663.89 / $3,086.00 / $5,995.00	Facility		$663.89	$3,086.00	$5,995.00
United Facility/Professional Professional Modifier Low / Median / High Price $524.98 / $706.47 / $1,032.79	Professional		$524.98	$706.47	$1,032.79