Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $0.65 / $1,842.00 / $6,524.16	Facility		$0.65	$1,842.00	$6,524.16
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $0.59 / $0.59 / $5,500.00	Facility	50	$0.59	$0.59	$5,500.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $151.02 / $287.82 / $8,498.12	Facility	52	$151.02	$287.82	$8,498.12
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $60.41 / $115.13 / $118.21	Facility	53	$60.41	$115.13	$118.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $302.04 / $369.05 / $618.85	Professional		$302.04	$369.05	$618.85
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,259.12 / $4,853.62 / $8,464.29	Facility		$2,259.12	$4,853.62	$8,464.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $366.03 / $588.66 / $693.84	Professional		$366.03	$588.66	$693.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $709.00 / $709.00 / $735.00	Facility		$709.00	$709.00	$735.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $324.50 / $433.38 / $621.99	Professional		$324.50	$433.38	$621.99
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $345.40 / $507.78 / $1,631.35	Professional		$345.40	$507.78	$1,631.35
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 $353.48 / $380.04 / $412.57	Professional		$353.48	$380.04	$412.57
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $476.04	Professional		$32.34	$32.34	$476.04
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 $323.20 / $450.05 / $795.12	Professional		$323.20	$450.05	$795.12