Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $289.00 / $361.25 / $7,838.38	Facility		$289.00	$361.25	$7,838.38
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $222.48 / $222.48 / $233.93	Facility	54	$222.48	$222.48	$233.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $239.21 / $287.45 / $545.17	Professional		$239.21	$287.45	$545.17
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $197.88 / $233.93 / $484.56	Professional	54	$197.88	$233.93	$484.56
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $289.89 / $289.89 / $289.89	Professional		$289.89	$289.89	$289.89
BCBS Facility/Professional Facility Modifier Low / Median / High Price $167.59 / $614.54 / $1,001.38	Facility		$167.59	$614.54	$1,001.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.98 / $360.17 / $501.43	Professional		$125.98	$360.17	$501.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $242.47 / $398.45 / $523.36	Professional		$242.47	$398.45	$523.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $52.86 / $440.57	Professional		$32.34	$52.86	$440.57
Providence Facility/Professional Facility Modifier Low / Median / High Price $177.80 / $280.75 / $363.80	Facility		$177.80	$280.75	$363.80
Providence Facility/Professional Professional Modifier Low / Median / High Price $286.39 / $423.35 / $715.46	Professional		$286.39	$423.35	$715.46
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $455.60 / $553.01 / $884.26	Professional	54	$455.60	$553.01	$884.26
United Facility/Professional Facility Modifier Low / Median / High Price $230.00 / $1,158.00 / $1,401.00	Facility		$230.00	$1,158.00	$1,401.00
United Facility/Professional Professional Modifier Low / Median / High Price $280.50 / $416.50 / $688.50	Professional		$280.50	$416.50	$688.50