Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.15 / $1,281.66 / $4,421.92	Facility		$436.15	$1,281.66	$4,421.92
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $129.69 / $332.35 / $640.83	Facility	52	$129.69	$332.35	$640.83
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $51.88 / $132.94 / $256.33	Facility	53	$51.88	$132.94	$256.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.18 / $563.69 / $1,122.21	Professional		$257.18	$563.69	$1,122.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $228.59 / $228.59 / $301.70	Professional		$228.59	$228.59	$301.70
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,409.27 / $2,286.12 / $7,018.22	Facility		$1,409.27	$2,286.12	$7,018.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $289.89 / $640.14 / $1,273.84	Professional		$289.89	$640.14	$1,273.84
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 $347.70 / $347.70 / $347.70	Facility	52	$347.70	$347.70	$347.70
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $86.93 / $86.93 / $86.93	Facility	53	$86.93	$86.93	$86.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $295.63 / $623.64 / $1,169.29	Professional		$295.63	$623.64	$1,169.29
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $346.42 / $890.21 / $1,816.06	Professional		$346.42	$890.21	$1,816.06
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 $301.54 / $321.67 / $853.98	Professional		$301.54	$321.67	$853.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $965.66	Professional		$32.34	$32.34	$965.66
United Facility/Professional Facility Modifier Low / Median / High Price $815.00 / $2,588.00 / $4,780.00	Facility		$815.00	$2,588.00	$4,780.00
United Facility/Professional Professional Modifier Low / Median / High Price $650.26 / $868.50 / $1,500.81	Professional		$650.26	$868.50	$1,500.81