Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,083.00 / $1,821.00 / $3,663.00	Facility		$1,083.00	$1,821.00	$3,663.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $680.50 / $909.74 / $981.98	Facility	54	$680.50	$909.74	$981.98
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $136.10 / $181.95 / $196.40	Facility	55	$136.10	$181.95	$196.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $671.72 / $907.33 / $1,309.31	Professional		$671.72	$907.33	$1,309.31
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $435.08 / $680.50 / $981.98	Professional	54	$435.08	$680.50	$981.98
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $87.02 / $136.10 / $200.14	Professional	55	$87.02	$136.10	$200.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $613.04 / $1,056.53 / $1,248.82	Professional		$613.04	$1,056.53	$1,248.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,196.23 / $2,196.23 / $2,635.48	Facility		$2,196.23	$2,196.23	$2,635.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $790.23 / $1,045.89 / $1,162.09	Professional		$790.23	$1,045.89	$1,162.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $854.46 / $854.46 / $854.46	Facility		$854.46	$854.46	$854.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,450.89 / $2,450.89 / $2,450.89	Facility		$2,450.89	$2,450.89	$2,450.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $548.54 / $1,259.60 / $1,460.36	Professional		$548.54	$1,259.60	$1,460.36
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $705.01 / $1,312.51 / $1,421.92	Professional		$705.01	$1,312.51	$1,421.92
United Facility/Professional Facility Modifier Low / Median / High Price $950.00 / $1,511.00 / $4,064.00	Facility		$950.00	$1,511.00	$4,064.00
United Facility/Professional Professional Modifier Low / Median / High Price $652.17 / $956.38 / $1,442.23	Professional		$652.17	$956.38	$1,442.23