Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $251.19 / $1,621.81 / $5,128.61	Facility		$251.19	$1,621.81	$5,128.61
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $977.24 / $2,884.03 / $5,248.07	Facility	50	$977.24	$2,884.03	$5,248.07
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $1,584.89 / $1,584.89 / $1,584.89	Facility	53	$1,584.89	$1,584.89	$1,584.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $245.47 / $831.76	Professional		$107.15	$245.47	$831.76
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $190.55 / $1,548.82	Professional	22	$141.25	$190.55	$1,548.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $398.11 / $1,412.54	Professional	50	$158.49	$398.11	$1,412.54
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $51.29 / $138.04 / $186.21	Professional	53	$51.29	$138.04	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $162.18 / $269.15	Professional		$97.72	$162.18	$269.15
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $229.09 / $371.54	Professional	50	$147.91	$229.09	$371.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,096.48 / $1,288.25 / $2,290.87	Facility		$1,096.48	$1,288.25	$2,290.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $239.88 / $416.87	Professional		$131.83	$239.88	$416.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $933.25 / $933.25 / $933.25	Facility		$933.25	$933.25	$933.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $223.87 / $426.58	Professional		$114.82	$223.87	$426.58
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $147.91 / $147.91 / $147.91	Professional	53	$147.91	$147.91	$147.91
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $363.08 / $1,202.26	Professional		$141.25	$363.08	$1,202.26
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 $131.83 / $138.04 / $316.23	Professional		$131.83	$138.04	$316.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $32.36 / $33.11	Professional		$32.36	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $1,479.11 / $3,801.89	Facility		$724.44	$1,479.11	$3,801.89
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $218.78 / $436.52	Professional		$109.65	$218.78	$436.52