Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $2,884.03 / $4,786.30	Facility		$288.40	$2,884.03	$4,786.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $436.52 / $1,174.90	Professional		$194.98	$436.52	$1,174.90
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $169.82 / $537.03 / $1,445.44	Professional	52	$169.82	$537.03	$1,445.44
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $158.49 / $208.93 / $588.84	Professional	53	$158.49	$208.93	$588.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $457.09	Professional		$165.96	$173.78	$457.09
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $57.54 / $57.54 / $57.54	Professional	52	$57.54	$57.54	$57.54
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $158.49 / $158.49 / $158.49	Professional	53	$158.49	$158.49	$158.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $3,090.30 / $5,128.61	Facility		$724.44	$3,090.30	$5,128.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $416.87 / $537.03	Professional		$239.88	$416.87	$537.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $338.84 / $741.31	Facility		$338.84	$338.84	$741.31
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $407.38 / $407.38 / $407.38	Facility	22	$407.38	$407.38	$407.38
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $269.15 / $269.15 / $269.15	Facility	52	$269.15	$269.15	$269.15
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $67.61 / $67.61 / $67.61	Facility	53	$67.61	$67.61	$67.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $446.68 / $758.58	Professional		$239.88	$446.68	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $602.56	Professional		$32.36	$33.11	$602.56
Providence Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $457.09 / $794.33	Facility		$208.93	$457.09	$794.33
Providence Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $467.74 / $812.83	Professional		$239.88	$467.74	$812.83
United Facility/Professional Facility Modifier Low / Median / High Price $562.34 / $3,467.37 / $5,248.07	Facility		$562.34	$3,467.37	$5,248.07
United Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $436.52 / $776.25	Professional		$251.19	$436.52	$776.25