Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,147.32 / $9,633.29 / $29,103.52	Facility		$2,147.32	$9,633.29	$29,103.52
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,930.47 / $1,930.47 / $1,930.47	Facility	22	$1,930.47	$1,930.47	$1,930.47
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $5,519.00 / $23,208.83 / $23,208.83	Facility	50	$5,519.00	$23,208.83	$23,208.83
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $988.25 / $1,916.23 / $2,030.96	Facility	54	$988.25	$1,916.23	$2,030.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,082.58 / $1,663.99 / $5,751.30	Professional		$1,082.58	$1,663.99	$5,751.30
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $168.45 / $306.60 / $981.55	Professional	AS	$168.45	$306.60	$981.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,125.28 / $1,685.41 / $2,012.74	Professional		$1,125.28	$1,685.41	$2,012.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $13,568.63 / $18,375.30 / $31,564.69	Facility		$13,568.63	$18,375.30	$31,564.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,573.20 / $2,203.17 / $2,651.49	Professional		$1,573.20	$2,203.17	$2,651.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $908.00 / $14,648.00 / $18,009.55	Facility		$908.00	$14,648.00	$18,009.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,326.29 / $1,896.09 / $3,121.05	Professional		$1,326.29	$1,896.09	$3,121.05
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $1,515.76 / $2,210.48 / $8,171.63	Professional		$1,515.76	$2,210.48	$8,171.63
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 $1,495.29 / $1,642.07 / $1,825.86	Professional		$1,495.29	$1,642.07	$1,825.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $2,064.63	Professional		$32.34	$32.34	$2,064.63
United Facility/Professional Facility Modifier Low / Median / High Price $2,421.00 / $7,842.00 / $21,651.00	Facility		$2,421.00	$7,842.00	$21,651.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,318.80 / $1,938.24 / $3,037.98	Professional		$1,318.80	$1,938.24	$3,037.98