Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.63 / $226.00 / $3,698.26	Facility		$41.63	$226.00	$3,698.26
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $55.88 / $472.00 / $1,881.90	Facility	50	$55.88	$472.00	$1,881.90
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $14.41 / $19.32 / $24.32	Facility	52	$14.41	$19.32	$24.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.81 / $47.03 / $111.35	Professional		$28.81	$47.03	$111.35
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $55.64 / $82.56 / $170.04	Professional	50	$55.64	$82.56	$170.04
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.36 / $20.82 / $25.42	Professional	52	$14.36	$20.82	$25.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.27 / $60.53 / $67.86	Professional		$30.27	$60.53	$67.86
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $66.06 / $90.80 / $98.14	Professional	50	$66.06	$90.80	$98.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,088.00 / $4,247.00 / $9,663.00	Facility		$2,088.00	$4,247.00	$9,663.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $47.60 / $77.03	Professional		$30.00	$47.60	$77.03
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $45.00 / $71.40 / $115.54	Professional	50	$45.00	$71.40	$115.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.61 / $64.03 / $114.62	Professional		$34.61	$64.03	$114.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.25 / $59.92 / $719.00	Facility		$30.25	$59.92	$719.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $315.07 / $315.07 / $315.07	Facility	50	$315.07	$315.07	$315.07
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $116.25 / $116.25 / $116.25	Facility	52	$116.25	$116.25	$116.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.33 / $95.67 / $356.96	Professional		$50.33	$95.67	$356.96
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $88.52 / $88.52 / $88.52	Professional		$88.52	$88.52	$88.52
United Facility/Professional Facility Modifier Low / Median / High Price $245.00 / $760.00 / $1,300.00	Facility		$245.00	$760.00	$1,300.00
United Facility/Professional Professional Modifier Low / Median / High Price $49.08 / $64.31 / $110.27	Professional		$49.08	$64.31	$110.27