Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.08 / $1,471.00 / $5,389.00	Facility		$331.08	$1,471.00	$5,389.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $6,092.03 / $6,092.03 / $6,092.03	Facility	50	$6,092.03	$6,092.03	$6,092.03
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $101.58 / $284.41 / $678.68	Facility	52	$101.58	$284.41	$678.68
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $40.63 / $113.76 / $271.47	Facility	53	$40.63	$113.76	$271.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $205.52 / $581.86 / $1,344.11	Professional		$205.52	$581.86	$1,344.11
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,485.82 / $3,096.34 / $5,693.02	Facility		$1,485.82	$3,096.34	$5,693.02
BCBS Facility/Professional Professional Modifier Low / Median / High Price $241.83 / $719.03 / $1,709.44	Professional		$241.83	$719.03	$1,709.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $875.00 / $875.00 / $908.00	Facility		$875.00	$875.00	$908.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $241.13 / $486.94 / $1,459.80	Professional		$241.13	$486.94	$1,459.80
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $282.39 / $1,202.58 / $2,303.87	Professional		$282.39	$1,202.58	$2,303.87
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 $238.56 / $253.18 / $1,136.36	Professional		$238.56	$253.18	$1,136.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,311.20	Professional		$32.34	$32.34	$1,311.20
United Facility/Professional Facility Modifier Low / Median / High Price $930.00 / $3,951.00 / $6,625.00	Facility		$930.00	$3,951.00	$6,625.00
United Facility/Professional Professional Modifier Low / Median / High Price $902.02 / $1,231.17 / $1,917.45	Professional		$902.02	$1,231.17	$1,917.45