Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $665.76 / $5,107.20 / $9,499.35	Facility		$665.76	$5,107.20	$9,499.35
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,750.00 / $3,815.00 / $9,955.50	Facility	50	$1,750.00	$3,815.00	$9,955.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $368.06 / $512.49 / $1,086.47	Professional		$368.06	$512.49	$1,086.47
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $626.25 / $1,006.28 / $1,409.60	Professional	50	$626.25	$1,006.28	$1,409.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $366.32 / $447.31 / $732.65	Professional		$366.32	$447.31	$732.65
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $1,098.97 / $1,098.97 / $1,098.97	Professional	50	$1,098.97	$1,098.97	$1,098.97
BCBS Facility/Professional Facility Modifier Low / Median / High Price $861.54 / $3,327.89 / $6,951.90	Facility		$861.54	$3,327.89	$6,951.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.10 / $500.73 / $854.46	Professional		$416.10	$500.73	$854.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $505.00 / $742.64 / $1,512.28	Facility		$505.00	$742.64	$1,512.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $457.71 / $592.79 / $1,030.80	Professional		$457.71	$592.79	$1,030.80
Medcost Facility/Professional Facility Modifier Low / Median / High Price $453.31 / $573.98 / $949.41	Facility		$453.31	$573.98	$949.41
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $745.82 / $954.09 / $1,658.45	Facility	50	$745.82	$954.09	$1,658.45
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,300.71 / $1,300.71 / $1,300.71	Professional		$1,300.71	$1,300.71	$1,300.71
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $1,951.06 / $1,951.06 / $1,951.06	Professional	50	$1,951.06	$1,951.06	$1,951.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.90 / $412.96 / $689.53	Professional		$69.90	$412.96	$689.53
United Facility/Professional Facility Modifier Low / Median / High Price $1,550.00 / $10,257.00 / $16,249.00	Facility		$1,550.00	$10,257.00	$16,249.00
United Facility/Professional Professional Modifier Low / Median / High Price $354.75 / $488.69 / $1,108.54	Professional		$354.75	$488.69	$1,108.54