Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $219.75 / $528.00 / $9,727.00	Facility		$219.75	$528.00	$9,727.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $164.81 / $175.34 / $396.00	Facility	54	$164.81	$175.34	$396.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $163.97 / $219.75 / $369.74	Professional		$163.97	$219.75	$369.74
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $135.97 / $155.60 / $235.72	Professional	54	$135.97	$155.60	$235.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.93 / $197.93 / $347.35	Professional		$197.93	$197.93	$347.35
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $137.36 / $140.56 / $140.56	Professional	54	$137.36	$140.56	$140.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $208.64 / $409.97 / $711.67	Facility		$208.64	$409.97	$711.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.00 / $191.80 / $292.72	Professional		$140.00	$191.80	$292.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $210.80 / $329.43	Facility		$100.00	$210.80	$329.43
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $230.60 / $230.60 / $230.60	Facility	54	$230.60	$230.60	$230.60
Cigna Facility/Professional Professional Modifier Low / Median / High Price $166.78 / $247.28 / $451.78	Professional		$166.78	$247.28	$451.78
Medcost Facility/Professional Facility Modifier Low / Median / High Price $185.63 / $241.73 / $409.79	Facility		$185.63	$241.73	$409.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $168.16 / $168.16 / $168.16	Professional		$168.16	$168.16	$168.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.57 / $148.85 / $266.60	Professional		$31.57	$148.85	$266.60
United Facility/Professional Facility Modifier Low / Median / High Price $225.00 / $1,221.00 / $3,585.00	Facility		$225.00	$1,221.00	$3,585.00
United Facility/Professional Professional Modifier Low / Median / High Price $159.72 / $210.64 / $465.39	Professional		$159.72	$210.64	$465.39