Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $625.00 / $3,612.00 / $7,500.00	Facility		$625.00	$3,612.00	$7,500.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $160.01 / $160.01 / $169.82	Facility	54	$160.01	$160.01	$169.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.61 / $213.35 / $280.77	Professional		$175.61	$213.35	$280.77
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $135.19 / $161.75 / $169.82	Professional	54	$135.19	$161.75	$169.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $316.77 / $316.77 / $316.77	Professional		$316.77	$316.77	$316.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,200.80 / $1,878.12 / $2,945.72	Facility		$1,200.80	$1,878.12	$2,945.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $197.57 / $260.24 / $310.95	Professional		$197.57	$260.24	$310.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $207.85 / $207.85 / $207.85	Facility		$207.85	$207.85	$207.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.07 / $263.54 / $341.08	Professional		$186.07	$263.54	$341.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $203.79 / $275.33 / $998.32	Facility		$203.79	$275.33	$998.32
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $681.37 / $681.37 / $681.37	Facility	54	$681.37	$681.37	$681.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $182.72 / $240.49 / $1,670.64	Professional		$182.72	$240.49	$1,670.64
United Facility/Professional Facility Modifier Low / Median / High Price $105.76 / $604.50 / $1,883.00	Facility		$105.76	$604.50	$1,883.00
United Facility/Professional Professional Modifier Low / Median / High Price $180.74 / $225.92 / $322.07	Professional		$180.74	$225.92	$322.07