Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $516.52 / $1,892.00 / $5,327.91	Facility		$516.52	$1,892.00	$5,327.91
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $783.84 / $2,334.33 / $10,787.32	Facility	22	$783.84	$2,334.33	$10,787.32
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $166.46 / $319.80 / $373.61	Facility	52	$166.46	$319.80	$373.61
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $66.58 / $127.92 / $151.55	Facility	53	$66.58	$127.92	$151.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $320.82 / $472.50 / $665.23	Professional		$320.82	$472.50	$665.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $270.41 / $395.61 / $432.50	Professional		$270.41	$395.61	$432.50
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,907.91 / $3,773.51 / $6,445.39	Facility		$1,907.91	$3,773.51	$6,445.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $375.32 / $449.66 / $581.66	Professional		$375.32	$449.66	$581.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $908.00 / $2,769.00	Facility		$400.00	$908.00	$2,769.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $291.99 / $291.99 / $291.99	Facility	52	$291.99	$291.99	$291.99
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $73.00 / $73.00 / $73.00	Facility	53	$73.00	$73.00	$73.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $311.61 / $464.42 / $689.45	Professional		$311.61	$464.42	$689.45
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $348.77 / $539.00 / $2,496.89	Professional		$348.77	$539.00	$2,496.89
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 $386.61 / $412.18 / $447.21	Professional		$386.61	$412.18	$447.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $505.69	Professional		$32.34	$32.34	$505.69
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 $335.72 / $491.14 / $757.60	Professional		$335.72	$491.14	$757.60