Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $817.39 / $817.39 / $1,400.00	Facility		$817.39	$817.39	$1,400.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $408.70 / $408.70 / $408.70	Facility	52	$408.70	$408.70	$408.70
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $163.47 / $163.47 / $163.47	Facility	53	$163.47	$163.47	$163.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $812.58 / $812.58 / $1,009.81	Facility		$812.58	$812.58	$1,009.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $873.50 / $873.50 / $873.50	Facility		$873.50	$873.50	$873.50
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $681.22 / $681.22 / $681.22	Facility	52	$681.22	$681.22	$681.22
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $170.30 / $170.30 / $170.30	Facility	53	$170.30	$170.30	$170.30
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $532.20 / $532.20 / $532.20	Facility	62	$532.20	$532.20	$532.20