Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $927.20 / $2,517.12 / $4,579.00	Facility		$927.20	$2,517.12	$4,579.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $81.64 / $81.64 / $620.04	Facility	52	$81.64	$81.64	$620.04
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $32.65 / $32.65 / $248.02	Facility	53	$32.65	$32.65	$248.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $150.87 / $221.65 / $1,562.57	Professional		$150.87	$221.65	$1,562.57
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.22 / $165.27 / $941.22	Professional		$130.22	$165.27	$941.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $884.32 / $2,952.41 / $4,751.77	Facility		$884.32	$2,952.41	$4,751.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.58 / $183.27 / $1,238.02	Professional		$96.58	$183.27	$1,238.02
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.77 / $257.77 / $1,023.75	Facility		$257.77	$257.77	$1,023.75
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 $179.08 / $279.52 / $1,801.97	Professional		$179.08	$279.52	$1,801.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $289.07 / $1,484.54	Professional		$32.34	$289.07	$1,484.54
Providence Facility/Professional Facility Modifier Low / Median / High Price $150.97 / $241.07 / $1,240.08	Facility		$150.97	$241.07	$1,240.08
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $206.22 / $206.22 / $206.22	Facility	52	$206.22	$206.22	$206.22
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $51.55 / $51.55 / $51.55	Facility	53	$51.55	$51.55	$51.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $197.37 / $361.94 / $2,447.39	Professional		$197.37	$361.94	$2,447.39
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 $219.49 / $1,304.09 / $2,204.55	Professional		$219.49	$1,304.09	$2,204.55