Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $917.02 / $917.02 / $917.02	Facility	50	$917.02	$917.02	$917.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $234.69 / $296.17 / $620.79	Professional		$234.69	$296.17	$620.79
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $306.77 / $416.31 / $635.69	Professional	50	$306.77	$416.31	$635.69
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $186.42 / $873.93 / $1,047.55	Professional	54	$186.42	$873.93	$1,047.55
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $37.28 / $163.86 / $196.42	Professional	55	$37.28	$163.86	$196.42
BCBS Facility/Professional Facility Modifier Low / Median / High Price $47,000.00 / $81,499.99 / $94,999.99	Facility		$47,000.00	$81,499.99	$94,999.99
BCBS Facility/Professional Professional Modifier Low / Median / High Price $320.20 / $320.20 / $384.36	Professional		$320.20	$320.20	$384.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $320.20 / $320.20 / $320.20	Facility		$320.20	$320.20	$320.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $209.98 / $320.20 / $555.80	Professional		$209.98	$320.20	$555.80
Providence Facility/Professional Facility Modifier Low / Median / High Price $312.64 / $365.63 / $1,183.32	Facility		$312.64	$365.63	$1,183.32
Providence Facility/Professional Professional Modifier Low / Median / High Price $208.20 / $320.20 / $456.51	Professional		$208.20	$320.20	$456.51
United Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $400.00 / $400.00	Facility		$400.00	$400.00	$400.00
United Facility/Professional Professional Modifier Low / Median / High Price $363.49 / $412.42 / $510.18	Professional		$363.49	$412.42	$510.18