Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $353.53 / $1,378.00 / $7,838.38	Facility		$353.53	$1,378.00	$7,838.38
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $245.97 / $245.97 / $265.14	Facility	54	$245.97	$245.97	$265.14
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $49.19 / $49.19 / $53.03	Facility	55	$49.19	$49.19	$53.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $267.56 / $338.63 / $1,504.00	Professional		$267.56	$338.63	$1,504.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $815.07 / $816.74 / $2,346.00	Professional	50	$815.07	$816.74	$2,346.00
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $245.97 / $362.79 / $1,241.96	Professional	54	$245.97	$362.79	$1,241.96
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $49.19 / $73.19 / $265.54	Professional	55	$49.19	$73.19	$265.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $288.44 / $288.44 / $308.31	Professional		$288.44	$288.44	$308.31
BCBS Facility/Professional Facility Modifier Low / Median / High Price $536.03 / $1,928.01 / $2,880.24	Facility		$536.03	$1,928.01	$2,880.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $140.93 / $362.45 / $466.68	Professional		$140.93	$362.45	$466.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,300.00 / $1,300.00 / $1,300.00	Facility		$1,300.00	$1,300.00	$1,300.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $241.58 / $443.74 / $593.82	Professional		$241.58	$443.74	$593.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $278.27 / $493.55	Professional		$32.34	$278.27	$493.55
Providence Facility/Professional Facility Modifier Low / Median / High Price $230.30 / $314.00 / $839.97	Facility		$230.30	$314.00	$839.97
Providence Facility/Professional Professional Modifier Low / Median / High Price $244.83 / $440.19 / $572.75	Professional		$244.83	$440.19	$572.75
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $499.20 / $499.20 / $499.20	Professional	54	$499.20	$499.20	$499.20
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $124.80 / $124.80 / $124.80	Professional	55	$124.80	$124.80	$124.80
United Facility/Professional Facility Modifier Low / Median / High Price $350.00 / $2,358.00 / $2,877.00	Facility		$350.00	$2,358.00	$2,877.00
United Facility/Professional Professional Modifier Low / Median / High Price $326.08 / $460.60 / $661.52	Professional		$326.08	$460.60	$661.52