Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $341.09 / $1,007.15 / $4,992.27	Facility		$341.09	$1,007.15	$4,992.27
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,391.25 / $1,391.25 / $1,391.25	Facility	22	$1,391.25	$1,391.25	$1,391.25
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $100.55 / $221.49 / $348.57	Facility	52	$100.55	$221.49	$348.57
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $40.22 / $88.59 / $139.43	Facility	53	$40.22	$88.59	$139.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $183.33 / $352.15 / $697.14	Professional		$183.33	$352.15	$697.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $101.59 / $138.40 / $274.49	Professional		$101.59	$138.40	$274.49
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,143.68 / $2,175.50 / $5,441.18	Facility		$1,143.68	$2,175.50	$5,441.18
BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.06 / $434.50 / $855.23	Professional		$227.06	$434.50	$855.23
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 $231.55 / $433.78 / $794.96	Professional		$231.55	$433.78	$794.96
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $273.64 / $616.33 / $1,373.45	Professional		$273.64	$616.33	$1,373.45
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 / $579.51	Professional		$233.91	$251.00	$579.51
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $655.29	Professional		$32.34	$32.34	$655.29
United Facility/Professional Facility Modifier Low / Median / High Price $1,183.00 / $2,476.00 / $4,164.00	Facility		$1,183.00	$2,476.00	$4,164.00
United Facility/Professional Professional Modifier Low / Median / High Price $418.17 / $610.29 / $923.28	Professional		$418.17	$610.29	$923.28