Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $847.00 / $4,790.00 / $12,424.17	Facility		$847.00	$4,790.00	$12,424.17
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $416.09 / $416.09 / $465.31	Facility	54	$416.09	$416.09	$465.31
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $83.22 / $83.22 / $93.06	Facility	55	$83.22	$83.22	$93.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $554.79 / $832.18 / $1,267.11	Professional		$554.79	$832.18	$1,267.11
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $416.09 / $579.04 / $950.34	Professional	54	$416.09	$579.04	$950.34
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $83.22 / $115.50 / $160.06	Professional	55	$83.22	$115.50	$160.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $631.90 / $728.87 / $1,204.77	Professional		$631.90	$728.87	$1,204.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $975.00 / $1,210.38 / $12,450.00	Facility		$975.00	$1,210.38	$12,450.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $580.48 / $961.35 / $1,950.97	Professional		$580.48	$961.35	$1,950.97
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $3,105.00 / $5,731.00 / $11,037.00	Facility		$3,105.00	$5,731.00	$11,037.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $453.00 / $550.12 / $1,003.07	Professional		$453.00	$550.12	$1,003.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $75.30 / $557.39 / $989.80	Professional		$75.30	$557.39	$989.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,681.00 / $5,811.00 / $10,057.00	Facility		$1,681.00	$5,811.00	$10,057.00
United Facility/Professional Professional Modifier Low / Median / High Price $589.76 / $805.84 / $1,429.48	Professional		$589.76	$805.84	$1,429.48
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $564.01 / $564.01 / $564.01	Professional		$564.01	$564.01	$564.01