Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $2,187.76 / $7,762.47	Facility		$338.84	$2,187.76	$7,762.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $245.47 / $660.69	Professional		$109.65	$245.47	$660.69
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $128.82 / $363.08	Professional		$69.18	$128.82	$363.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,318.26 / $2,570.40	Facility		$537.03	$1,318.26	$2,570.40
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $302.00 / $457.09	Professional		$114.82	$302.00	$457.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $407.38 / $831.76	Facility		$204.17	$407.38	$831.76
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $245.47 / $245.47 / $245.47	Facility	22	$245.47	$245.47	$245.47
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $165.96 / $165.96 / $165.96	Facility	52	$165.96	$165.96	$165.96
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $41.69 / $41.69 / $41.69	Facility	53	$41.69	$41.69	$41.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $302.00 / $602.56	Professional		$147.91	$302.00	$602.56
Medcost Facility/Professional Professional Modifier Low / Median / High Price $426.58 / $426.58 / $457.09	Professional		$426.58	$426.58	$457.09
Medcost Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $295.12 / $549.54	Facility		$138.04	$295.12	$549.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Professional		$281.84	$281.84	$281.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $616.60 / $6,165.95 / $10,000.00	Facility		$616.60	$6,165.95	$10,000.00
United Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $245.47 / $467.74	Professional		$114.82	$245.47	$467.74