Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $428.88 / $3,508.40 / $9,707.54	Facility		$428.88	$3,508.40	$9,707.54
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,508.39 / $3,508.39 / $5,114.14	Facility	50	$3,508.39	$3,508.39	$5,114.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $166.27 / $307.11 / $632.63	Professional		$166.27	$307.11	$632.63
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $193.67 / $362.04 / $775.50	Professional	50	$193.67	$362.04	$775.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $159.91 / $235.75 / $277.36	Professional		$159.91	$235.75	$277.36
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $203.88 / $239.86 / $416.04	Professional	50	$203.88	$239.86	$416.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,218.59 / $4,049.54 / $8,116.91	Facility		$1,218.59	$4,049.54	$8,116.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $148.75 / $301.48 / $439.90	Professional		$148.75	$301.48	$439.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $505.00 / $1,007.90 / $1,295.17	Facility		$505.00	$1,007.90	$1,295.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $206.08 / $322.27 / $514.54	Professional		$206.08	$322.27	$514.54
Medcost Facility/Professional Facility Modifier Low / Median / High Price $192.36 / $323.00 / $475.86	Facility		$192.36	$323.00	$475.86
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $415.50 / $525.00 / $712.50	Facility	50	$415.50	$525.00	$712.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $831.70 / $891.75 / $1,036.14	Professional		$831.70	$891.75	$1,036.14
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $1,247.55 / $1,247.55 / $1,554.21	Professional	50	$1,247.55	$1,247.55	$1,554.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $219.54 / $299.85 / $467.70	Professional		$219.54	$299.85	$467.70
United Facility/Professional Facility Modifier Low / Median / High Price $659.00 / $6,607.00 / $8,667.00	Facility		$659.00	$6,607.00	$8,667.00
United Facility/Professional Professional Modifier Low / Median / High Price $241.16 / $385.83 / $669.09	Professional		$241.16	$385.83	$669.09