Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $600.00 / $1,875.50 / $5,828.46	Facility		$600.00	$1,875.50	$5,828.46
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $77.29 / $214.66 / $889.24	Facility	52	$77.29	$214.66	$889.24
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $30.92 / $85.86 / $355.69	Facility	53	$30.92	$85.86	$355.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $146.97 / $293.35 / $1,691.50	Professional		$146.97	$293.35	$1,691.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.87 / $147.12 / $270.77	Professional		$89.87	$147.12	$270.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $993.29 / $2,369.92 / $3,401.23	Facility		$993.29	$2,369.92	$3,401.23
BCBS Facility/Professional Professional Modifier Low / Median / High Price $174.69 / $746.09 / $1,597.50	Professional		$174.69	$746.09	$1,597.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $1,200.00 / $2,769.00	Facility		$400.00	$1,200.00	$2,769.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $175.28 / $335.85 / $1,757.59	Professional		$175.28	$335.85	$1,757.59
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $208.16 / $1,179.58 / $2,046.90	Professional		$208.16	$1,179.58	$2,046.90
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 $178.98 / $191.07 / $1,330.49	Professional		$178.98	$191.07	$1,330.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,504.47	Professional		$32.34	$32.34	$1,504.47
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 $206.83 / $1,141.19 / $2,306.28	Professional		$206.83	$1,141.19	$2,306.28