Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $298.95 / $1,309.34 / $5,192.00	Facility		$298.95	$1,309.34	$5,192.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $62.78 / $149.47 / $391.72	Facility	52	$62.78	$149.47	$391.72
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $25.11 / $59.79 / $156.69	Facility	53	$25.11	$59.79	$156.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $96.22 / $179.76 / $459.05	Professional		$96.22	$179.76	$459.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $89.57 / $149.15 / $183.99	Professional		$89.57	$149.15	$183.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $603.00 / $1,153.76 / $2,103.48	Facility		$603.00	$1,153.76	$2,103.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.95 / $216.00 / $376.29	Professional		$101.95	$216.00	$376.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $375.00 / $569.33 / $663.59	Facility		$375.00	$569.33	$663.59
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 $132.06 / $283.91 / $598.44	Professional		$132.06	$283.91	$598.44
Medcost Facility/Professional Facility Modifier Low / Median / High Price $122.74 / $344.18 / $525.98	Facility		$122.74	$344.18	$525.98
Medcost Facility/Professional Professional Modifier Low / Median / High Price $178.51 / $399.08 / $746.50	Professional		$178.51	$399.08	$746.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $219.46 / $297.71 / $455.02	Professional		$219.46	$297.71	$455.02
United Facility/Professional Facility Modifier Low / Median / High Price $586.00 / $6,172.00 / $8,667.00	Facility		$586.00	$6,172.00	$8,667.00
United Facility/Professional Professional Modifier Low / Median / High Price $262.58 / $368.01 / $706.02	Professional		$262.58	$368.01	$706.02