Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $322.35 / $975.00 / $3,109.00	Facility		$322.35	$975.00	$3,109.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $201.12 / $250.73 / $385.16	Facility	54	$201.12	$250.73	$385.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $219.62 / $268.18 / $422.26	Professional		$219.62	$268.18	$422.26
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $137.63 / $211.13 / $343.65	Professional	54	$137.63	$211.13	$343.65
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $27.53 / $42.23 / $68.73	Professional	55	$27.53	$42.23	$68.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $332.89 / $332.89 / $414.91	Professional		$332.89	$332.89	$414.91
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $499.34 / $499.34 / $622.37	Professional	50	$499.34	$499.34	$622.37
BCBS Facility/Professional Facility Modifier Low / Median / High Price $539.80 / $539.80 / $647.77	Facility		$539.80	$539.80	$647.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $250.47 / $331.51 / $418.19	Professional		$250.47	$331.51	$418.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $534.97 / $534.97 / $534.97	Facility		$534.97	$534.97	$534.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.98 / $411.37 / $559.59	Professional		$277.98	$411.37	$559.59
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $382.82 / $382.82 / $477.15	Professional		$382.82	$382.82	$477.15
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $574.24 / $574.24 / $715.73	Professional	50	$574.24	$574.24	$715.73
United Facility/Professional Facility Modifier Low / Median / High Price $330.00 / $811.00 / $1,574.00	Facility		$330.00	$811.00	$1,574.00
United Facility/Professional Professional Modifier Low / Median / High Price $260.44 / $383.00 / $569.36	Professional		$260.44	$383.00	$569.36