Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,188.90 / $8,523.20 / $22,854.11	Facility		$2,188.90	$8,523.20	$22,854.11
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $22,172.25 / $22,172.25 / $22,172.25	Facility	22	$22,172.25	$22,172.25	$22,172.25
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $20,198.00 / $20,198.00 / $20,198.00	Facility	50	$20,198.00	$20,198.00	$20,198.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $989.41 / $1,918.19 / $2,032.81	Facility	54	$989.41	$1,918.19	$2,032.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,190.75 / $1,740.79 / $5,218.72	Professional		$1,190.75	$1,740.79	$5,218.72
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $129.85 / $255.19 / $953.67	Professional	AS	$129.85	$255.19	$953.67
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,126.63 / $1,631.11 / $1,898.76	Professional		$1,126.63	$1,631.11	$1,898.76
BCBS Facility/Professional Facility Modifier Low / Median / High Price $13,260.50 / $18,375.30 / $30,847.90	Facility		$13,260.50	$18,375.30	$30,847.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,575.42 / $2,178.44 / $2,654.91	Professional		$1,575.42	$2,178.44	$2,654.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $908.00 / $18,331.00 / $18,385.93	Facility		$908.00	$18,331.00	$18,385.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,324.18 / $1,898.76 / $3,107.51	Professional		$1,324.18	$1,898.76	$3,107.51
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,500.30 / $2,213.33 / $7,715.39	Professional		$1,500.30	$2,213.33	$7,715.39
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,497.04 / $1,644.19 / $1,828.44	Professional		$1,497.04	$1,644.19	$1,828.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $2,067.54	Professional		$32.34	$32.34	$2,067.54
United Facility/Professional Facility Modifier Low / Median / High Price $2,421.00 / $8,100.00 / $21,651.00	Facility		$2,421.00	$8,100.00	$21,651.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,298.47 / $1,768.84 / $3,040.21	Professional		$1,298.47	$1,768.84	$3,040.21