Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.13 / $1,580.04 / $3,525.32	Facility		$208.13	$1,580.04	$3,525.32
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $969.95 / $2,875.66 / $5,005.10	Facility	50	$969.95	$2,875.66	$5,005.10
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.33 / $47.10 / $77.70	Facility	53	$21.33	$47.10	$77.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $217.18 / $610.15	Professional		$95.09	$217.18	$610.15
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.52 / $191.19 / $1,551.25	Professional	22	$141.52	$191.19	$1,551.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $148.93 / $374.54 / $1,497.60	Professional	50	$148.93	$374.54	$1,497.60
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $19.02 / $40.49 / $71.39	Professional	53	$19.02	$40.49	$71.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.70 / $159.11 / $222.99	Professional		$100.70	$159.11	$222.99
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $152.77 / $238.66 / $330.37	Professional	50	$152.77	$238.66	$330.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,046.76 / $1,349.24 / $2,435.09	Facility		$1,046.76	$1,349.24	$2,435.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $132.58 / $246.09 / $416.06	Professional		$132.58	$246.09	$416.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $463.00 / $929.98 / $1,038.21	Facility		$463.00	$929.98	$1,038.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $115.74 / $227.20 / $421.82	Professional		$115.74	$227.20	$421.82
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $146.34 / $345.40 / $1,038.68	Professional		$146.34	$345.40	$1,038.68
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 $133.24 / $137.88 / $319.45	Professional		$133.24	$137.88	$319.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $361.22	Professional		$32.34	$32.34	$361.22
United Facility/Professional Facility Modifier Low / Median / High Price $807.00 / $1,763.00 / $4,256.00	Facility		$807.00	$1,763.00	$4,256.00
United Facility/Professional Professional Modifier Low / Median / High Price $218.59 / $341.20 / $547.45	Professional		$218.59	$341.20	$547.45