Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $637.22 / $4,846.00 / $13,326.29	Facility		$637.22	$4,846.00	$13,326.29
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $127.44 / $127.44 / $209.11	Facility	53	$127.44	$127.44	$209.11
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $477.92 / $477.92 / $784.16	Facility	54	$477.92	$477.92	$784.16
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $95.58 / $95.58 / $156.83	Facility	55	$95.58	$95.58	$156.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $615.75 / $677.44 / $860.24	Professional		$615.75	$677.44	$860.24
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.58 / $101.62 / $129.04	Professional	55	$95.58	$101.62	$129.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $618.66 / $618.66 / $618.66	Professional		$618.66	$618.66	$618.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,976.00 / $9,518.00 / $26,304.00	Facility		$1,976.00	$9,518.00	$26,304.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $507.83 / $636.83 / $857.93	Professional		$507.83	$636.83	$857.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $552.16 / $804.27 / $958.94	Facility		$552.16	$804.27	$958.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $618.66 / $773.34 / $887.09	Professional		$618.66	$773.34	$887.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $450.00 / $646.00 / $5,038.64	Facility		$450.00	$646.00	$5,038.64
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $151.22 / $151.22 / $151.22	Facility	53	$151.22	$151.22	$151.22
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $529.26 / $529.26 / $529.26	Facility	54	$529.26	$529.26	$529.26
Cigna Facility/Professional Facility Modifier 55 Low / Median / High Price $113.41 / $113.41 / $113.41	Facility	55	$113.41	$113.41	$113.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $605.28 / $815.15 / $1,091.58	Professional		$605.28	$815.15	$1,091.58
United Facility/Professional Facility Modifier Low / Median / High Price $2,721.00 / $10,000.00 / $15,750.00	Facility		$2,721.00	$10,000.00	$15,750.00
United Facility/Professional Professional Modifier Low / Median / High Price $609.32 / $789.78 / $1,385.88	Professional		$609.32	$789.78	$1,385.88