Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $293.06 / $3,776.00 / $9,727.00	Facility		$293.06	$3,776.00	$9,727.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $219.80 / $278.27 / $598.65	Facility	54	$219.80	$278.27	$598.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $226.59 / $293.06 / $501.52	Professional		$226.59	$293.06	$501.52
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $169.94 / $219.80 / $279.14	Professional	54	$169.94	$219.80	$279.14
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $33.99 / $43.96 / $55.83	Professional	55	$33.99	$43.96	$55.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $214.16 / $267.91 / $370.99	Professional		$214.16	$267.91	$370.99
BCBS Facility/Professional Facility Modifier Low / Median / High Price $671.77 / $1,224.32 / $2,100.88	Facility		$671.77	$1,224.32	$2,100.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $227.20 / $457.66 / $651.07	Professional		$227.20	$457.66	$651.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.11 / $295.11 / $295.11	Facility		$295.11	$295.11	$295.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $264.89 / $390.49 / $724.27	Professional		$264.89	$390.49	$724.27
Medcost Facility/Professional Facility Modifier Low / Median / High Price $271.94 / $382.44 / $598.16	Facility		$271.94	$382.44	$598.16
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $413.21 / $690.00 / $1,020.00	Facility	50	$413.21	$690.00	$1,020.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $302.27 / $302.27 / $302.27	Professional		$302.27	$302.27	$302.27
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $453.42 / $453.42 / $453.42	Professional	50	$453.42	$453.42	$453.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.82 / $235.24 / $342.79	Professional		$31.82	$235.24	$342.79
United Facility/Professional Facility Modifier Low / Median / High Price $461.00 / $3,866.00 / $6,584.00	Facility		$461.00	$3,866.00	$6,584.00
United Facility/Professional Professional Modifier Low / Median / High Price $266.57 / $327.31 / $631.79	Professional		$266.57	$327.31	$631.79