Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $414.07 / $885.42 / $9,062.00	Facility		$414.07	$885.42	$9,062.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $289.22 / $310.55 / $664.06	Facility	54	$289.22	$310.55	$664.06
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $57.84 / $62.11 / $132.81	Facility	55	$57.84	$62.11	$132.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $251.77 / $371.01 / $521.60	Professional		$251.77	$371.01	$521.60
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $470.54 / $470.54 / $565.88	Professional	50	$470.54	$470.54	$565.88
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $223.42 / $289.22 / $310.55	Professional	54	$223.42	$289.22	$310.55
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $44.68 / $57.84 / $62.11	Professional	55	$44.68	$57.84	$62.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $279.86 / $300.92 / $464.04	Professional		$279.86	$300.92	$464.04
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $451.38 / $451.38 / $451.38	Professional	50	$451.38	$451.38	$451.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $573.25 / $1,217.82 / $2,108.12	Facility		$573.25	$1,217.82	$2,108.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.82 / $392.00 / $574.11	Professional		$295.82	$392.00	$574.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $481.55 / $481.55 / $505.00	Facility		$481.55	$481.55	$505.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $257.45 / $375.05 / $757.75	Professional		$257.45	$375.05	$757.75
Medcost Facility/Professional Facility Modifier Low / Median / High Price $269.51 / $371.77 / $650.00	Facility		$269.51	$371.77	$650.00
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $352.50 / $557.66 / $1,048.55	Facility	50	$352.50	$557.66	$1,048.55
Medcost Facility/Professional Professional Modifier Low / Median / High Price $410.59 / $410.59 / $660.00	Professional		$410.59	$410.59	$660.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $615.88 / $615.88 / $615.88	Professional	50	$615.88	$615.88	$615.88
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.96 / $204.49 / $332.40	Professional		$33.96	$204.49	$332.40
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 $254.43 / $339.24 / $550.74	Professional		$254.43	$339.24	$550.74