Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $534.83 / $2,569.02 / $5,000.27	Facility		$534.83	$2,569.02	$5,000.27
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $98.13 / $98.13 / $187.56	Facility	52	$98.13	$98.13	$187.56
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $75.02 / $145.80 / $267.41	Facility	53	$75.02	$145.80	$267.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.05 / $341.34 / $615.04	Professional		$186.05	$341.34	$615.04
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $40.72 / $93.51 / $215.30	Professional	53	$40.72	$93.51	$215.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.27 / $213.27 / $213.27	Professional		$213.27	$213.27	$213.27
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $62.73 / $78.80 / $157.80	Professional	53	$62.73	$78.80	$157.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $780.50 / $3,073.55 / $4,946.74	Facility		$780.50	$3,073.55	$4,946.74
BCBS Facility/Professional Professional Modifier Low / Median / High Price $209.48 / $349.14 / $471.34	Professional		$209.48	$349.14	$471.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $310.83 / $310.83 / $579.87	Facility		$310.83	$310.83	$579.87
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 $228.03 / $382.09 / $651.21	Professional		$228.03	$382.09	$651.21
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $160.38 / $160.38 / $298.33	Professional	53	$160.38	$160.38	$298.33
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $94.92 / $506.77	Professional		$32.34	$94.92	$506.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $191.57 / $348.02 / $559.66	Facility		$191.57	$348.02	$559.66
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $248.66 / $248.66 / $248.66	Facility	52	$248.66	$248.66	$248.66
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $62.17 / $62.17 / $62.17	Facility	53	$62.17	$62.17	$62.17
Providence Facility/Professional Professional Modifier Low / Median / High Price $250.62 / $415.04 / $738.78	Professional		$250.62	$415.04	$738.78
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 $357.95 / $530.27 / $699.01	Professional		$357.95	$530.27	$699.01
United Facility/Professional Professional Modifier 53 Low / Median / High Price $164.56 / $164.56 / $422.53	Professional	53	$164.56	$164.56	$422.53