Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $167.55 / $1,637.80 / $5,000.27	Facility		$167.55	$1,637.80	$5,000.27
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $56.72 / $56.72 / $163.41	Facility	52	$56.72	$56.72	$163.41
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $22.69 / $22.69 / $65.37	Facility	53	$22.69	$22.69	$65.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $279.00 / $543.91	Professional		$97.14	$279.00	$543.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.77 / $99.77 / $99.77	Professional		$99.77	$99.77	$99.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $803.12 / $1,979.15 / $3,227.73	Facility		$803.12	$1,979.15	$3,227.73
BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.21 / $264.74 / $373.33	Professional		$126.21	$264.74	$373.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $179.49 / $179.49 / $596.36	Facility		$179.49	$179.49	$596.36
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.82 / $237.39 / $516.79	Professional		$121.82	$237.39	$516.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $80.01 / $422.77	Professional		$32.34	$80.01	$422.77
Providence Facility/Professional Facility Modifier Low / Median / High Price $100.18 / $259.08 / $419.18	Facility		$100.18	$259.08	$419.18
Providence Facility/Professional Facility Modifier 52 Low / Median / High Price $143.59 / $143.59 / $143.59	Facility	52	$143.59	$143.59	$143.59
Providence Facility/Professional Facility Modifier 53 Low / Median / High Price $35.90 / $35.90 / $35.90	Facility	53	$35.90	$35.90	$35.90
Providence Facility/Professional Professional Modifier Low / Median / High Price $127.12 / $311.06 / $634.36	Professional		$127.12	$311.06	$634.36
United Facility/Professional Facility Modifier Low / Median / High Price $755.00 / $3,085.00 / $5,060.00	Facility		$755.00	$3,085.00	$5,060.00
United Facility/Professional Professional Modifier Low / Median / High Price $308.16 / $470.80 / $627.21	Professional		$308.16	$470.80	$627.21