Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $786.31 / $3,402.49 / $8,736.57	Facility		$786.31	$3,402.49	$8,736.57
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $108.36 / $256.00 / $420.55	Facility	52	$108.36	$256.00	$420.55
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $79.73 / $168.22 / $421.29	Facility	53	$79.73	$168.22	$421.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $186.68 / $347.01 / $841.09	Professional		$186.68	$347.01	$841.09
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $43.34 / $108.36 / $253.19	Professional	53	$43.34	$108.36	$253.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $155.00 / $258.33 / $305.42	Professional		$155.00	$258.33	$305.42
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $76.18 / $106.40 / $153.22	Professional	53	$76.18	$106.40	$153.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $561.85 / $1,354.15 / $2,630.93	Facility		$561.85	$1,354.15	$2,630.93
BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.16 / $416.16 / $768.14	Professional		$178.16	$416.16	$768.14
BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $85.12 / $153.63 / $210.09	Professional	53	$85.12	$153.63	$210.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $553.59 / $645.24	Facility		$375.00	$553.59	$645.24
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 $229.45 / $404.80 / $678.66	Professional		$229.45	$404.80	$678.66
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $116.81 / $116.81 / $116.81	Professional	53	$116.81	$116.81	$116.81
Medcost Facility/Professional Facility Modifier Low / Median / High Price $216.72 / $451.61 / $643.08	Facility		$216.72	$451.61	$643.08
Medcost Facility/Professional Professional Modifier Low / Median / High Price $350.00 / $528.00 / $820.58	Professional		$350.00	$528.00	$820.58
Medcost Facility/Professional Professional Modifier 53 Low / Median / High Price $411.40 / $411.40 / $478.20	Professional	53	$411.40	$411.40	$478.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $154.55 / $269.96 / $453.89	Professional		$154.55	$269.96	$453.89
United Facility/Professional Facility Modifier Low / Median / High Price $586.00 / $6,172.00 / $8,667.00	Facility		$586.00	$6,172.00	$8,667.00
United Facility/Professional Professional Modifier Low / Median / High Price $281.12 / $397.94 / $768.04	Professional		$281.12	$397.94	$768.04
United Facility/Professional Professional Modifier 53 Low / Median / High Price $120.27 / $267.31 / $267.31	Professional	53	$120.27	$267.31	$267.31