Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,760.00 / $3,781.85 / $7,594.00	Facility		$1,760.00	$3,781.85	$7,594.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $111.49 / $111.49 / $129.79	Facility	53	$111.49	$111.49	$129.79
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $418.07 / $451.10 / $4,316.00	Facility	54	$418.07	$451.10	$4,316.00
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $83.61 / $83.61 / $97.34	Facility	55	$83.61	$83.61	$97.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $483.75 / $619.58 / $1,490.97	Professional		$483.75	$619.58	$1,490.97
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $202.33 / $300.73 / $415.76	Professional	52	$202.33	$300.73	$415.76
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $387.01 / $451.10 / $1,011.00	Professional	54	$387.01	$451.10	$1,011.00
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $60.70 / $90.23 / $195.93	Professional	55	$60.70	$90.23	$195.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $454.34 / $580.50 / $798.40	Professional		$454.34	$580.50	$798.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,232.00 / $4,486.00 / $9,663.00	Facility		$2,232.00	$4,486.00	$9,663.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $667.95 / $877.14 / $1,288.72	Professional		$667.95	$877.14	$1,288.72
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $1,001.92 / $1,315.71 / $1,933.08	Professional	50	$1,001.92	$1,315.71	$1,933.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,344.16 / $6,956.00 / $10,254.00	Facility		$1,344.16	$6,956.00	$10,254.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $428.88 / $844.16 / $1,364.21	Professional		$428.88	$844.16	$1,364.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $601.46 / $2,291.00 / $26,542.00	Facility		$601.46	$2,291.00	$26,542.00
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $281.10 / $1,305.69 / $1,305.69	Facility	53	$281.10	$1,305.69	$1,305.69
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $983.84 / $4,569.92 / $4,569.92	Facility	54	$983.84	$4,569.92	$4,569.92
Medica Facility/Professional Facility Modifier 55 Low / Median / High Price $210.82 / $979.27 / $979.27	Facility	55	$210.82	$979.27	$979.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $548.29 / $771.92 / $6,076.05	Professional		$548.29	$771.92	$6,076.05
Medica Facility/Professional Professional Modifier 54 Low / Median / High Price $519.59 / $896.99 / $944.20	Professional	54	$519.59	$896.99	$944.20
United Facility/Professional Facility Modifier Low / Median / High Price $1,694.00 / $2,849.00 / $5,200.00	Facility		$1,694.00	$2,849.00	$5,200.00
United Facility/Professional Professional Modifier Low / Median / High Price $529.70 / $710.37 / $1,457.74	Professional		$529.70	$710.37	$1,457.74