Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $682.00 / $3,683.00 / $7,500.00	Facility		$682.00	$3,683.00	$7,500.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $253.13 / $253.13 / $264.20	Facility	54	$253.13	$253.13	$264.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $247.37 / $337.50 / $428.62	Professional		$247.37	$337.50	$428.62
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $211.90 / $258.43 / $264.20	Professional	54	$211.90	$258.43	$264.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $333.14 / $333.14 / $333.14	Professional		$333.14	$333.14	$333.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,200.80 / $1,878.12 / $2,945.72	Facility		$1,200.80	$1,878.12	$2,945.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.80 / $408.48 / $488.08	Professional		$303.80	$408.48	$488.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $207.85 / $207.85 / $207.85	Facility		$207.85	$207.85	$207.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $252.96 / $375.37 / $519.54	Professional		$252.96	$375.37	$519.54
Medica Facility/Professional Facility Modifier Low / Median / High Price $303.67 / $403.02 / $1,177.78	Facility		$303.67	$403.02	$1,177.78
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $1,094.65 / $1,094.65 / $1,094.65	Facility	54	$1,094.65	$1,094.65	$1,094.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $266.88 / $350.35 / $2,607.36	Professional		$266.88	$350.35	$2,607.36
United Facility/Professional Facility Modifier Low / Median / High Price $139.00 / $610.00 / $1,883.00	Facility		$139.00	$610.00	$1,883.00
United Facility/Professional Professional Modifier Low / Median / High Price $257.41 / $320.64 / $483.93	Professional		$257.41	$320.64	$483.93