Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5,454.75 / $11,423.81 / $26,444.35	Facility		$5,454.75	$11,423.81	$26,444.35
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $16,853.95 / $16,853.95 / $16,853.95	Facility	22	$16,853.95	$16,853.95	$16,853.95
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $389.03 / $877.27 / $877.27	Facility	52	$389.03	$877.27	$877.27
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $155.61 / $350.91 / $350.91	Facility	53	$155.61	$350.91	$350.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $627.28 / $883.96 / $3,167.00	Professional		$627.28	$883.96	$3,167.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $659.78 / $1,098.60 / $1,206.04	Professional		$659.78	$1,098.60	$1,206.04
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,950.52 / $8,678.26 / $16,792.87	Facility		$3,950.52	$8,678.26	$16,792.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $613.75 / $1,000.00 / $1,920.09	Professional		$613.75	$1,000.00	$1,920.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $3,235.02 / $16,205.00	Facility		$375.00	$3,235.02	$16,205.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $594.13 / $594.13 / $594.13	Facility	52	$594.13	$594.13	$594.13
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $148.53 / $148.53 / $148.53	Facility	53	$148.53	$148.53	$148.53
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $74.27 / $74.27 / $74.27	Facility	AS	$74.27	$74.27	$74.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $675.12 / $919.34 / $1,730.75	Professional		$675.12	$919.34	$1,730.75
Medcost Facility/Professional Facility Modifier Low / Median / High Price $683.29 / $929.58 / $1,457.01	Facility		$683.29	$929.58	$1,457.01
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $173.80 / $233.42 / $277.13	Facility	80	$173.80	$233.42	$277.13
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $121.66 / $163.38 / $193.99	Facility	AS	$121.66	$163.38	$193.99
Medcost Facility/Professional Professional Modifier Low / Median / High Price $800.00 / $1,710.46 / $3,220.00	Professional		$800.00	$1,710.46	$3,220.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.35 / $597.18 / $972.12	Professional		$70.35	$597.18	$972.12
United Facility/Professional Facility Modifier Low / Median / High Price $2,098.00 / $16,269.00 / $24,161.00	Facility		$2,098.00	$16,269.00	$24,161.00
United Facility/Professional Professional Modifier Low / Median / High Price $564.97 / $796.44 / $1,579.51	Professional		$564.97	$796.44	$1,579.51