Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $410.75 / $2,797.19 / $7,650.42	Facility		$410.75	$2,797.19	$7,650.42
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $771.31 / $1,287.71 / $9,016.76	Facility	22	$771.31	$1,287.71	$9,016.76
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $100.85 / $217.24 / $363.70	Facility	52	$100.85	$217.24	$363.70
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $40.34 / $86.89 / $145.47	Facility	53	$40.34	$86.89	$145.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $195.69 / $399.88 / $945.13	Professional		$195.69	$399.88	$945.13
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.76 / $199.09 / $365.39	Professional	52	$97.76	$199.09	$365.39
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $38.84 / $77.68 / $145.47	Professional	53	$38.84	$77.68	$145.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.93 / $221.03 / $437.59	Professional		$167.93	$221.03	$437.59
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $42.85 / $44.62 / $71.20	Professional	52	$42.85	$44.62	$71.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,147.16 / $2,175.50 / $5,457.71	Facility		$1,147.16	$2,175.50	$5,457.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.06 / $414.44 / $814.91	Professional		$227.06	$414.44	$814.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $1,200.00 / $2,769.00	Facility		$400.00	$1,200.00	$2,769.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $270.52 / $270.52 / $270.52	Facility	52	$270.52	$270.52	$270.52
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.63 / $67.63 / $67.63	Facility	53	$67.63	$67.63	$67.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $232.69 / $439.02 / $790.95	Professional		$232.69	$439.02	$790.95
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $273.64 / $605.04 / $1,329.47	Professional		$273.64	$605.04	$1,329.47
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 $233.91 / $251.00 / $568.75	Professional		$233.91	$251.00	$568.75
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $643.13	Professional		$32.34	$32.34	$643.13
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 $415.88 / $559.66 / $949.07	Professional		$415.88	$559.66	$949.07