Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $604.52 / $1,442.86 / $5,000.27	Facility		$604.52	$1,442.86	$5,000.27
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $94.07 / $94.07 / $213.49	Facility	52	$94.07	$94.07	$213.49
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $37.63 / $37.63 / $85.40	Facility	53	$37.63	$37.63	$85.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.37 / $256.16 / $553.59	Professional		$173.37	$256.16	$553.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $82.63 / $82.63 / $170.22	Professional		$82.63	$82.63	$170.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $780.50 / $2,952.41 / $4,751.77	Facility		$780.50	$2,952.41	$4,751.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.02 / $210.97 / $462.65	Professional		$112.02	$210.97	$462.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $296.61 / $296.61 / $596.36	Facility		$296.61	$296.61	$596.36
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 $206.66 / $322.68 / $641.64	Professional		$206.66	$322.68	$641.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $106.33 / $563.07	Professional		$32.34	$106.33	$563.07
Providence Facility/Professional Facility Modifier Low / Median / High Price $174.20 / $278.43 / $517.79	Facility		$174.20	$278.43	$517.79
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $237.29 / $237.29 / $237.29	Facility	52	$237.29	$237.29	$237.29
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $59.32 / $59.32 / $59.32	Facility	53	$59.32	$59.32	$59.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $228.09 / $390.00 / $843.06	Professional		$228.09	$390.00	$843.06
United Facility/Professional Facility Modifier Low / Median / High Price $755.00 / $3,085.00 / $5,060.00	Facility		$755.00	$3,085.00	$5,060.00
United Facility/Professional Professional Modifier Low / Median / High Price $252.39 / $449.17 / $750.48	Professional		$252.39	$449.17	$750.48