Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.68 / $1,207.00 / $4,764.39	Facility		$65.68	$1,207.00	$4,764.39
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $28.43 / $80.05 / $148.99	Facility	52	$28.43	$80.05	$148.99
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $11.37 / $32.02 / $59.60	Facility	53	$11.37	$32.02	$59.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.21 / $122.21 / $312.02	Professional		$54.21	$122.21	$312.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $25.41 / $58.99 / $72.40	Professional		$25.41	$58.99	$72.40
BCBS Facility/Professional Facility Modifier Low / Median / High Price $231.36 / $937.91 / $1,530.11	Facility		$231.36	$937.91	$1,530.11
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.81 / $184.55 / $309.44	Professional		$65.81	$184.55	$309.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $289.52 / $500.00 / $2,769.00	Facility		$289.52	$500.00	$2,769.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $76.54 / $76.54 / $76.54	Facility	52	$76.54	$76.54	$76.54
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $19.14 / $19.14 / $19.14	Facility	53	$19.14	$19.14	$19.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.59 / $142.07 / $309.54	Professional		$65.59	$142.07	$309.54
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $245.18 / $550.45	Professional		$76.73	$245.18	$550.45
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 $66.91 / $71.25 / $244.48	Professional		$66.91	$71.25	$244.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $276.45	Professional		$32.34	$32.34	$276.45
United Facility/Professional Facility Modifier Low / Median / High Price $680.00 / $1,553.00 / $4,043.00	Facility		$680.00	$1,553.00	$4,043.00
United Facility/Professional Professional Modifier Low / Median / High Price $146.84 / $207.49 / $372.71	Professional		$146.84	$207.49	$372.71