Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $369.25 / $1,761.00 / $4,683.16	Facility		$369.25	$1,761.00	$4,683.16
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $91.33 / $119.33 / $232.34	Facility	52	$91.33	$119.33	$232.34
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $36.53 / $47.73 / $92.93	Facility	53	$36.53	$47.73	$92.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $193.51 / $432.78 / $1,007.52	Professional		$193.51	$432.78	$1,007.52
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $97.10 / $199.94 / $286.14	Professional	52	$97.10	$199.94	$286.14
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $38.57 / $79.98 / $106.94	Professional	53	$38.57	$79.98	$106.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $171.92 / $248.89 / $406.84	Professional		$171.92	$248.89	$406.84
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $44.62 / $70.90 / $71.20	Professional	52	$44.62	$70.90	$71.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $770.00 / $1,508.00 / $3,523.00	Facility		$770.00	$1,508.00	$3,523.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $224.41 / $347.40 / $509.73	Professional		$224.41	$347.40	$509.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,213.00 / $2,769.00 / $4,641.00	Facility		$2,213.00	$2,769.00	$4,641.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $223.17 / $421.34 / $850.50	Professional		$223.17	$421.34	$850.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $207.38 / $451.88 / $1,380.00	Facility		$207.38	$451.88	$1,380.00
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $721.81 / $721.81 / $721.81	Facility	52	$721.81	$721.81	$721.81
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $180.45 / $180.45 / $180.45	Facility	53	$180.45	$180.45	$180.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $328.33 / $769.21 / $3,212.16	Professional		$328.33	$769.21	$3,212.16
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $121.99 / $121.99 / $121.99	Professional	52	$121.99	$121.99	$121.99
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.00 / $1,895.00 / $3,041.00	Facility		$1,380.00	$1,895.00	$3,041.00
United Facility/Professional Professional Modifier Low / Median / High Price $376.19 / $549.15 / $978.20	Professional		$376.19	$549.15	$978.20