Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $129.61 / $1,253.19 / $5,621.00	Facility		$129.61	$1,253.19	$5,621.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $12.15 / $25.92 / $49.36	Facility	53	$12.15	$25.92	$49.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.16 / $96.48 / $187.82	Professional		$47.16	$96.48	$187.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $70.06 / $148.52 / $148.52	Professional	50	$70.06	$148.52	$148.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.70 / $92.47 / $107.90	Professional		$50.70	$92.47	$107.90
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $161.86 / $161.86 / $161.86	Professional	50	$161.86	$161.86	$161.86
BCBS Facility/Professional Facility Modifier Low / Median / High Price $469.39 / $980.69 / $1,690.89	Facility		$469.39	$980.69	$1,690.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.52 / $152.41 / $321.26	Professional		$49.52	$152.41	$321.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.31 / $86.31 / $890.00	Facility		$86.31	$86.31	$890.00
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $17.26 / $17.26 / $17.26	Facility	53	$17.26	$17.26	$17.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.64 / $114.99 / $228.12	Professional		$70.64	$114.99	$228.12
Medcost Facility/Professional Facility Modifier Low / Median / High Price $60.73 / $134.02 / $258.00	Facility		$60.73	$134.02	$258.00
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $137.74 / $292.77 / $434.62	Facility	50	$137.74	$292.77	$434.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $82.31 / $112.07 / $172.70	Professional		$82.31	$112.07	$172.70
United Facility/Professional Facility Modifier Low / Median / High Price $225.00 / $1,221.00 / $3,585.00	Facility		$225.00	$1,221.00	$3,585.00
United Facility/Professional Professional Modifier Low / Median / High Price $84.43 / $121.91 / $282.25	Professional		$84.43	$121.91	$282.25