Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $138.28 / $3,776.00 / $9,727.00	Facility		$138.28	$3,776.00	$9,727.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $103.71 / $104.27 / $250.40	Facility	54	$103.71	$104.27	$250.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.88 / $129.58 / $201.03	Professional		$102.88	$129.58	$201.03
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $85.64 / $97.74 / $142.71	Professional	54	$85.64	$97.74	$142.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $80.54 / $80.54 / $161.07	Professional		$80.54	$80.54	$161.07
BCBS Facility/Professional Facility Modifier Low / Median / High Price $205.04 / $388.34 / $687.05	Facility		$205.04	$388.34	$687.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $129.66 / $209.08	Professional		$100.00	$129.66	$209.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $131.16 / $141.36	Facility		$100.00	$131.16	$141.36
Cigna Facility/Professional Facility Modifier 54 Low / Median / High Price $94.65 / $94.65 / $94.65	Facility	54	$94.65	$94.65	$94.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.06 / $160.47 / $309.18	Professional		$116.06	$160.47	$309.18
Medcost Facility/Professional Facility Modifier Low / Median / High Price $115.51 / $159.30 / $262.05	Facility		$115.51	$159.30	$262.05
Medcost Facility/Professional Professional Modifier Low / Median / High Price $123.87 / $123.87 / $123.87	Professional		$123.87	$123.87	$123.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.95 / $76.04 / $152.90	Professional		$29.95	$76.04	$152.90
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 $98.75 / $130.44 / $278.93	Professional		$98.75	$130.44	$278.93