Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.29 / $1,665.00 / $5,063.00	Facility		$76.29	$1,665.00	$5,063.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $151.31 / $1,482.00 / $3,294.00	Facility	50	$151.31	$1,482.00	$3,294.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.26 / $89.06 / $189.07	Professional		$46.26	$89.06	$189.07
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $125.41 / $125.41 / $677.80	Professional	50	$125.41	$125.41	$677.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.63 / $135.47 / $145.97	Professional		$117.63	$135.47	$145.97
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $759.49 / $2,152.57 / $4,143.39	Facility		$759.49	$2,152.57	$4,143.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.73 / $70.76 / $128.00	Professional		$47.73	$70.76	$128.00
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $72.00 / $106.15 / $192.00	Professional	50	$72.00	$106.15	$192.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.98 / $65.22 / $105.60	Facility		$53.98	$65.22	$105.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $96.20 / $97.00 / $168.65	Professional		$96.20	$97.00	$168.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.90 / $117.37 / $207.03	Professional		$59.90	$117.37	$207.03
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $47.02 / $79.45 / $170.62	Professional		$47.02	$79.45	$170.62
United Facility/Professional Facility Modifier Low / Median / High Price $212.00 / $1,550.00 / $2,665.00	Facility		$212.00	$1,550.00	$2,665.00
United Facility/Professional Professional Modifier Low / Median / High Price $83.25 / $138.93 / $200.08	Professional		$83.25	$138.93	$200.08