Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $741.31 / $5,011.87	Facility		$288.40	$741.31	$5,011.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $407.38 / $933.25	Professional		$190.55	$407.38	$933.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $93.33 / $120.23	Professional		$85.11	$93.33	$120.23
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 / $398.11 / $537.03	Professional		$239.88	$398.11	$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 / $426.58 / $758.58	Professional		$239.88	$426.58	$758.58
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $616.60	Professional		$32.36	$33.11	$616.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $457.09 / $776.25	Facility		$208.93	$457.09	$776.25
Providence Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $446.68 / $794.33	Professional		$239.88	$446.68	$794.33
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