Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $165.54 / $1,207.00 / $4,634.00	Facility		$165.54	$1,207.00	$4,634.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $44.79 / $123.44 / $191.45	Facility	52	$44.79	$123.44	$191.45
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $17.91 / $49.38 / $76.58	Facility	53	$17.91	$49.38	$76.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.30 / $183.39 / $382.89	Professional		$85.30	$183.39	$382.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $78.26 / $78.26 / $122.01	Professional		$78.26	$78.26	$122.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $575.54 / $1,221.66 / $1,758.57	Facility		$575.54	$1,221.66	$1,758.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.45 / $260.80 / $425.75	Professional		$101.45	$260.80	$425.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $300.00 / $864.62 / $2,769.00	Facility		$300.00	$864.62	$2,769.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $118.08 / $118.08 / $118.08	Facility	52	$118.08	$118.08	$118.08
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.52 / $29.52 / $29.52	Facility	53	$29.52	$29.52	$29.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.99 / $231.02 / $454.62	Professional		$101.99	$231.02	$454.62
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $122.13 / $362.66 / $952.58	Professional		$122.13	$362.66	$952.58
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 $102.48 / $109.88 / $342.94	Professional		$102.48	$109.88	$342.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $387.79	Professional		$32.34	$32.34	$387.79
United Facility/Professional Facility Modifier Low / Median / High Price $815.00 / $2,588.00 / $4,780.00	Facility		$815.00	$2,588.00	$4,780.00
United Facility/Professional Professional Modifier Low / Median / High Price $223.79 / $310.83 / $534.77	Professional		$223.79	$310.83	$534.77