Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $402.87 / $1,956.15 / $4,683.16	Facility		$402.87	$1,956.15	$4,683.16
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $62.93 / $173.51 / $207.17	Facility	52	$62.93	$173.51	$207.17
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $25.17 / $32.72 / $80.58	Facility	53	$25.17	$32.72	$80.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.05 / $242.38 / $719.25	Professional		$85.05	$242.38	$719.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.78 / $152.29 / $235.85	Professional		$71.78	$152.29	$235.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $770.00 / $1,508.00 / $3,523.00	Facility		$770.00	$1,508.00	$3,523.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $163.55 / $324.51 / $569.66	Professional		$163.55	$324.51	$569.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,213.00 / $2,769.00 / $4,641.00	Facility		$2,213.00	$2,769.00	$4,641.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $156.82 / $331.95 / $716.81	Professional		$156.82	$331.95	$716.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $142.84 / $381.72 / $1,217.95	Facility		$142.84	$381.72	$1,217.95
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $496.53 / $496.53 / $496.53	Facility	52	$496.53	$496.53	$496.53
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $124.13 / $124.13 / $124.13	Facility	53	$124.13	$124.13	$124.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $230.18 / $655.24 / $2,784.32	Professional		$230.18	$655.24	$2,784.32
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $180.81 / $180.81 / $271.23	Professional		$180.81	$180.81	$271.23
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.00 / $1,895.00 / $3,041.00	Facility		$1,380.00	$1,895.00	$3,041.00
United Facility/Professional Professional Modifier Low / Median / High Price $249.36 / $438.57 / $828.37	Professional		$249.36	$438.57	$828.37