Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $496.37 / $1,332.24 / $3,221.00	Facility		$496.37	$1,332.24	$3,221.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $843.62 / $2,464.55 / $2,464.55	Facility	50	$843.62	$2,464.55	$2,464.55
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $257.24 / $420.03 / $548.79	Facility	54	$257.24	$420.03	$548.79
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $51.45 / $84.01 / $109.44	Facility	55	$51.45	$84.01	$109.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.56 / $361.06 / $625.23	Professional		$267.56	$361.06	$625.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $436.08 / $478.47 / $1,987.04	Professional	50	$436.08	$478.47	$1,987.04
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $230.63 / $290.70 / $436.79	Professional	54	$230.63	$290.70	$436.79
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $46.13 / $58.14 / $87.36	Professional	55	$46.13	$58.14	$87.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $269.87 / $396.35 / $471.54	Professional		$269.87	$396.35	$471.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $754.86 / $3,231.06 / $7,047.35	Facility		$754.86	$3,231.06	$7,047.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $349.51 / $522.29 / $557.30	Professional		$349.51	$522.29	$557.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $620.00 / $620.00 / $643.00	Facility		$620.00	$620.00	$643.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $262.35 / $422.82 / $633.73	Professional		$262.35	$422.82	$633.73
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $276.56 / $466.96 / $1,215.16	Professional		$276.56	$466.96	$1,215.16
Hally Health Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Facility		$100.00	$100.00	$100.00
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $371.44 / $371.94 / $433.60	Professional		$371.44	$371.94	$433.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $490.30	Professional		$32.34	$32.34	$490.30
United Facility/Professional Facility Modifier Low / Median / High Price $553.00 / $1,905.00 / $4,342.00	Facility		$553.00	$1,905.00	$4,342.00
United Facility/Professional Professional Modifier Low / Median / High Price $295.67 / $392.51 / $706.12	Professional		$295.67	$392.51	$706.12