Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $674.76 / $860.00 / $8,229.00	Facility		$674.76	$860.00	$8,229.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $134.94 / $139.28 / $171.39	Facility	53	$134.94	$139.28	$171.39
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $506.07 / $522.30 / $642.73	Facility	54	$506.07	$522.30	$642.73
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $101.21 / $104.46 / $128.55	Facility	55	$101.21	$104.46	$128.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $609.66 / $696.41 / $1,090.59	Professional		$609.66	$696.41	$1,090.59
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $95.58 / $104.46 / $128.55	Professional	55	$95.58	$104.46	$128.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $613.41 / $613.41 / $613.41	Professional		$613.41	$613.41	$613.41
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 $431.65 / $523.07 / $800.00	Professional		$431.65	$523.07	$800.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $611.30 / $858.79 / $981.47	Facility		$611.30	$858.79	$981.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $613.41 / $858.79 / $1,226.83	Professional		$613.41	$858.79	$1,226.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $756.80 / $756.80 / $4,094.76	Facility		$756.80	$756.80	$4,094.76
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 $565.75 / $891.20 / $3,164.96	Professional		$565.75	$891.20	$3,164.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $544.25	Professional		$32.34	$32.34	$544.25
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 $609.32 / $790.88 / $1,233.25	Professional		$609.32	$790.88	$1,233.25