Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $630.96 / $3,162.28 / $7,413.10	Facility		$630.96	$3,162.28	$7,413.10
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $338.84 / $1,445.44 / $2,187.76	Facility	52	$338.84	$1,445.44	$2,187.76
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $66.07 / $128.82 / $309.03	Facility	53	$66.07	$128.82	$309.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $398.11 / $1,122.02	Professional		$181.97	$398.11	$1,122.02
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $79.43 / $154.88 / $309.03	Professional	53	$79.43	$154.88	$309.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $204.17 / $346.74	Professional		$154.88	$204.17	$346.74
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $43.65 / $85.11 / $154.88	Professional	53	$43.65	$85.11	$154.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $309.03 / $489.78 / $954.99	Facility		$309.03	$489.78	$954.99
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $371.54 / $371.54 / $371.54	Facility	22	$371.54	$371.54	$371.54
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $251.19 / $251.19 / $251.19	Facility	52	$251.19	$251.19	$251.19
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $61.66 / $61.66 / $478.63	Facility	53	$61.66	$61.66	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $338.84 / $630.96	Professional		$194.98	$338.84	$630.96
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $138.04 / $229.09 / $338.84	Professional	53	$138.04	$229.09	$338.84
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $2,137.96 / $3,235.94 / $6,606.93	Facility		$2,137.96	$3,235.94	$6,606.93
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $346.74 / $446.68	Professional		$190.55	$346.74	$446.68
Florida Blue Facility/Professional Professional Modifier 53 Low / Median / High Price $64.57 / $131.83 / $213.80	Professional	53	$64.57	$131.83	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $141.25 / $426.58	Professional		$32.36	$141.25	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $707.95 / $3,311.31 / $6,606.93	Facility		$707.95	$3,311.31	$6,606.93
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $302.00 / $524.81	Professional		$165.96	$302.00	$524.81
United Facility/Professional Professional Modifier 53 Low / Median / High Price $165.96 / $165.96 / $218.78	Professional	53	$165.96	$165.96	$218.78
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $371.54 / $407.38	Professional		$165.96	$371.54	$407.38
Wellpoint Facility/Professional Professional Modifier 53 Low / Median / High Price $141.25 / $186.21 / $257.04	Professional	53	$141.25	$186.21	$257.04