Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $170.14 / $1,167.00 / $8,988.00	Facility		$170.14	$1,167.00	$8,988.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $107.96 / $120.99 / $130.81	Facility	54	$107.96	$120.99	$130.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $152.50 / $193.00 / $302.31	Professional		$152.50	$193.00	$302.31
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $112.35 / $141.85 / $189.53	Professional	54	$112.35	$141.85	$189.53
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $194.11 / $194.94 / $243.67	Professional		$194.11	$194.94	$243.67
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $221.83 / $221.83 / $502.62	Professional	54	$221.83	$221.83	$502.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.73 / $128.51 / $152.99	Facility		$126.73	$128.51	$152.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.44 / $241.66 / $374.77	Professional		$158.44	$241.66	$374.77
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $1,438.00 / $2,403.00 / $4,241.00	Facility		$1,438.00	$2,403.00	$4,241.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $81.02 / $162.03 / $228.69	Professional		$81.02	$162.03	$228.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.92 / $147.22 / $259.20	Professional		$31.92	$147.22	$259.20
United Facility/Professional Facility Modifier Low / Median / High Price $366.00 / $1,950.00 / $5,107.00	Facility		$366.00	$1,950.00	$5,107.00
United Facility/Professional Professional Modifier Low / Median / High Price $141.30 / $197.82 / $363.35	Professional		$141.30	$197.82	$363.35
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.47 / $164.43 / $164.43	Professional		$154.47	$164.43	$164.43