Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.69 / $1,337.50 / $4,881.66	Facility		$210.69	$1,337.50	$4,881.66
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,026.69 / $3,082.28 / $3,272.16	Facility	50	$2,026.69	$3,082.28	$3,272.16
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $60.10 / $173.32 / $257.91	Facility	52	$60.10	$173.32	$257.91
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.04 / $60.95 / $103.16	Facility	53	$24.04	$60.95	$103.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $99.16 / $210.69 / $614.79	Professional		$99.16	$210.69	$614.79
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $96.08 / $96.08 / $150.93	Professional		$96.08	$96.08	$150.93
BCBS Facility/Professional Facility Modifier Low / Median / High Price $655.73 / $1,151.91 / $2,512.46	Facility		$655.73	$1,151.91	$2,512.46
BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.47 / $280.14 / $543.25	Professional		$126.47	$280.14	$543.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $875.00 / $908.00	Facility		$875.00	$875.00	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.85 / $292.12 / $874.25	Professional		$132.85	$292.12	$874.25
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $150.93 / $429.55 / $851.65	Professional		$150.93	$429.55	$851.65
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 $127.75 / $135.63 / $402.60	Professional		$127.75	$135.63	$402.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $464.54	Professional		$32.34	$32.34	$464.54
United Facility/Professional Facility Modifier Low / Median / High Price $553.00 / $1,763.00 / $4,342.00	Facility		$553.00	$1,763.00	$4,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $318.52 / $602.72 / $964.85	Professional		$318.52	$602.72	$964.85