Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $236.89 / $1,892.00 / $5,840.46	Facility		$236.89	$1,892.00	$5,840.46
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $89.06 / $192.25 / $314.60	Facility	52	$89.06	$192.25	$314.60
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $35.61 / $76.90 / $125.84	Facility	53	$35.61	$76.90	$125.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.19 / $315.60 / $651.58	Professional		$171.19	$315.60	$651.58
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $166.46 / $221.20	Professional		$87.56	$166.46	$221.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.76 / $1,681.00 / $3,448.14	Facility		$724.76	$1,681.00	$3,448.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $201.10 / $382.01 / $640.53	Professional		$201.10	$382.01	$640.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $979.50 / $2,769.00	Facility		$400.00	$979.50	$2,769.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.60 / $361.14 / $673.87	Professional		$200.60	$361.14	$673.87
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $239.63 / $504.54 / $1,166.09	Professional		$239.63	$504.54	$1,166.09
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 $205.56 / $219.97 / $502.03	Professional		$205.56	$219.97	$502.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $567.67	Professional		$32.34	$32.34	$567.67
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 $237.97 / $407.78 / $805.47	Professional		$237.97	$407.78	$805.47