Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $360.78 / $2,785.98 / $6,240.30	Facility		$360.78	$2,785.98	$6,240.30
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $150.84 / $267.44 / $1,060.23	Facility	52	$150.84	$267.44	$1,060.23
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $71.14 / $159.69 / $286.93	Facility	53	$71.14	$159.69	$286.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $182.49 / $326.77 / $813.87	Professional		$182.49	$326.77	$813.87
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $41.81 / $100.01 / $231.74	Professional	53	$41.81	$100.01	$231.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $172.22 / $212.95 / $317.61	Professional		$172.22	$212.95	$317.61
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $47.34 / $93.81 / $146.57	Professional	53	$47.34	$93.81	$146.57
BCBS Facility/Professional Facility Modifier Low / Median / High Price $993.28 / $1,682.17 / $4,725.63	Facility		$993.28	$1,682.17	$4,725.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $208.70 / $374.67 / $637.63	Professional		$208.70	$374.67	$637.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $1,693.00 / $2,490.00	Facility		$400.00	$1,693.00	$2,490.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $248.66 / $248.66 / $248.66	Facility	52	$248.66	$248.66	$248.66
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $62.17 / $62.17 / $62.17	Facility	53	$62.17	$62.17	$62.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $212.96 / $367.63 / $659.98	Professional		$212.96	$367.63	$659.98
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $116.81 / $187.26 / $336.15	Professional	53	$116.81	$187.26	$336.15
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $251.54 / $486.30 / $1,288.04	Professional		$251.54	$486.30	$1,288.04
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 $215.10 / $230.70 / $451.57	Professional		$215.10	$230.70	$451.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $220.56 / $510.62	Professional		$32.34	$220.56	$510.62
United Facility/Professional Facility Modifier Low / Median / High Price $815.00 / $2,664.00 / $4,391.00	Facility		$815.00	$2,664.00	$4,391.00
United Facility/Professional Professional Modifier Low / Median / High Price $322.95 / $482.92 / $786.72	Professional		$322.95	$482.92	$786.72
United Facility/Professional Professional Modifier 53 Low / Median / High Price $85.00 / $217.30 / $428.87	Professional	53	$85.00	$217.30	$428.87