Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,678.00 / $7,069.50 / $25,332.00	Facility		$2,678.00	$7,069.50	$25,332.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $20,696.62 / $20,696.62 / $20,696.62	Facility	22	$20,696.62	$20,696.62	$20,696.62
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,253.00 / $35,236.50 / $35,236.50	Facility	50	$2,253.00	$35,236.50	$35,236.50
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $854.33 / $1,858.30 / $2,546.88	Facility	54	$854.33	$1,858.30	$2,546.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,139.09 / $1,399.65 / $3,193.34	Professional		$1,139.09	$1,399.65	$3,193.34
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $159.50 / $378.29 / $836.81	Professional	AS	$159.50	$378.29	$836.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,148.79 / $1,608.31 / $2,125.26	Professional		$1,148.79	$1,608.31	$2,125.26
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,430.00 / $7,178.00 / $13,734.00	Facility		$2,430.00	$7,178.00	$13,734.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,294.97 / $1,793.78 / $2,833.36	Professional		$1,294.97	$1,793.78	$2,833.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $30.00 / $30.00	Facility		$30.00	$30.00	$30.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,377.56 / $1,918.45 / $2,821.29	Professional		$1,377.56	$1,918.45	$2,821.29
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $10,780.38 / $53,594.95 / $53,594.95	Facility		$10,780.38	$53,594.95	$53,594.95
Lucent Health Facility/Professional Facility Modifier 54 Low / Median / High Price $2,273.19 / $35,560.28 / $35,560.28	Facility	54	$2,273.19	$35,560.28	$35,560.28
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $2,029.64 / $31,750.25 / $31,750.25	Facility	62	$2,029.64	$31,750.25	$31,750.25
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $324.74 / $5,080.04 / $5,080.04	Facility	AS	$324.74	$5,080.04	$5,080.04
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $13,550.61 / $13,550.61 / $13,550.61	Professional		$13,550.61	$13,550.61	$13,550.61
United Facility/Professional Facility Modifier Low / Median / High Price $5,052.00 / $14,004.00 / $29,870.00	Facility		$5,052.00	$14,004.00	$29,870.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,231.10 / $1,595.44 / $2,817.54	Professional		$1,231.10	$1,595.44	$2,817.54