Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $613.71 / $2,507.00 / $5,691.00	Facility		$613.71	$2,507.00	$5,691.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $117.74 / $153.34 / $356.37	Facility	52	$117.74	$153.34	$356.37
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $47.10 / $61.33 / $142.55	Facility	53	$47.10	$61.33	$142.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $250.26 / $607.60 / $1,461.65	Professional		$250.26	$607.60	$1,461.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $221.65 / $364.14 / $428.70	Professional		$221.65	$364.14	$428.70
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 $289.85 / $429.73 / $650.29	Professional		$289.85	$429.73	$650.29
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 $285.24 / $585.66 / $1,276.26	Professional		$285.24	$585.66	$1,276.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $264.57 / $661.70 / $1,673.08	Facility		$264.57	$661.70	$1,673.08
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $926.46 / $926.46 / $926.46	Facility	52	$926.46	$926.46	$926.46
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $231.61 / $231.61 / $231.61	Facility	53	$231.61	$231.61	$231.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $664.84 / $1,374.42 / $4,908.96	Professional		$664.84	$1,374.42	$4,908.96
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $395.80 / $395.80 / $395.80	Professional		$395.80	$395.80	$395.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,380.00 / $2,332.00 / $3,041.00	Facility		$1,380.00	$2,332.00	$3,041.00
United Facility/Professional Professional Modifier Low / Median / High Price $622.58 / $894.33 / $1,580.48	Professional		$622.58	$894.33	$1,580.48