Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $284.70 / $1,543.60 / $4,751.00	Facility		$284.70	$1,543.60	$4,751.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,512.32 / $2,717.04 / $4,288.77	Facility	50	$2,512.32	$2,717.04	$4,288.77
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $25.98 / $56.94 / $116.21	Facility	53	$25.98	$56.94	$116.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.19 / $219.71 / $500.48	Professional		$103.19	$219.71	$500.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.41 / $349.97 / $1,932.90	Professional	50	$158.41	$349.97	$1,932.90
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $21.74 / $42.53 / $56.94	Professional	53	$21.74	$42.53	$56.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $110.93 / $205.01 / $394.59	Professional		$110.93	$205.01	$394.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $170.26 / $277.07 / $355.46	Professional	50	$170.26	$277.07	$355.46
BCBS Facility/Professional Facility Modifier Low / Median / High Price $558.22 / $1,324.61 / $2,702.15	Facility		$558.22	$1,324.61	$2,702.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.35 / $256.00 / $455.35	Professional		$108.35	$256.00	$455.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $188.07 / $580.00 / $781.44	Facility		$188.07	$580.00	$781.44
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $37.61 / $37.61 / $37.61	Facility	53	$37.61	$37.61	$37.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.72 / $247.13 / $468.79	Professional		$128.72	$247.13	$468.79
Medcost Facility/Professional Facility Modifier Low / Median / High Price $129.90 / $300.35 / $523.00	Facility		$129.90	$300.35	$523.00
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $294.64 / $538.50 / $872.63	Facility	50	$294.64	$538.50	$872.63
Medcost Facility/Professional Professional Modifier Low / Median / High Price $671.62 / $671.62 / $671.62	Professional		$671.62	$671.62	$671.62
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $1,007.42 / $1,007.42 / $1,007.42	Professional	50	$1,007.42	$1,007.42	$1,007.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $192.04 / $261.03 / $400.21	Professional		$192.04	$261.03	$400.21
United Facility/Professional Facility Modifier Low / Median / High Price $490.00 / $3,866.00 / $6,584.00	Facility		$490.00	$3,866.00	$6,584.00
United Facility/Professional Professional Modifier Low / Median / High Price $191.11 / $252.05 / $556.83	Professional		$191.11	$252.05	$556.83