Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $845.31 / $1,032.00 / $8,229.00	Facility		$845.31	$1,032.00	$8,229.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $633.98 / $655.59 / $807.92	Facility	54	$633.98	$655.59	$807.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $761.10 / $874.12 / $1,077.31	Professional		$761.10	$874.12	$1,077.31
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $119.70 / $131.12 / $161.58	Professional	55	$119.70	$131.12	$161.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,567.00 / $4,022.00 / $7,848.00	Facility		$2,567.00	$4,022.00	$7,848.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $542.59 / $657.50 / $900.00	Professional		$542.59	$657.50	$900.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $765.04 / $1,075.83 / $1,229.54	Facility		$765.04	$1,075.83	$1,229.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $845.31 / $1,075.83 / $1,536.92	Professional		$845.31	$1,075.83	$1,536.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $949.72 / $949.72 / $4,098.22	Facility		$949.72	$949.72	$4,098.22
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $662.09 / $662.09 / $662.09	Facility	54	$662.09	$662.09	$662.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $708.78 / $1,119.91 / $3,952.30	Professional		$708.78	$1,119.91	$3,952.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $684.12	Professional		$32.34	$32.34	$684.12
United Facility/Professional Facility Modifier Low / Median / High Price $842.00 / $4,539.00 / $10,113.00	Facility		$842.00	$4,539.00	$10,113.00
United Facility/Professional Professional Modifier Low / Median / High Price $764.24 / $1,000.81 / $1,633.16	Professional		$764.24	$1,000.81	$1,633.16