Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,162.50 / $4,002.34 / $10,050.48	Facility		$1,162.50	$4,002.34	$10,050.48
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $695.45 / $14,756.00 / $24,473.64	Facility	50	$695.45	$14,756.00	$24,473.64
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $615.62 / $1,084.09 / $1,241.88	Facility	54	$615.62	$1,084.09	$1,241.88
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $123.12 / $216.82 / $248.38	Facility	55	$123.12	$216.82	$248.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $738.24 / $972.37 / $1,916.89	Professional		$738.24	$972.37	$1,916.89
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $553.67 / $701.84 / $1,084.09	Professional	54	$553.67	$701.84	$1,084.09
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $110.74 / $140.37 / $216.82	Professional	55	$110.74	$140.37	$216.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $673.49 / $673.49 / $697.22	Professional		$673.49	$673.49	$697.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,138.27 / $7,732.62 / $16,865.83	Facility		$3,138.27	$7,732.62	$16,865.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $841.30 / $1,192.34 / $1,519.01	Professional		$841.30	$1,192.34	$1,519.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,346.00 / $5,891.00 / $7,782.00	Facility		$1,346.00	$5,891.00	$7,782.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $719.96 / $1,045.56 / $1,512.63	Professional		$719.96	$1,045.56	$1,512.63
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $668.35 / $1,169.41 / $2,845.20	Professional		$668.35	$1,169.41	$2,845.20
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 $886.69 / $900.67 / $976.42	Professional		$886.69	$900.67	$976.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $1,104.09	Professional		$32.34	$32.34	$1,104.09
United Facility/Professional Facility Modifier Low / Median / High Price $1,080.00 / $3,951.00 / $6,625.00	Facility		$1,080.00	$3,951.00	$6,625.00
United Facility/Professional Professional Modifier Low / Median / High Price $807.40 / $1,124.70 / $1,761.77	Professional		$807.40	$1,124.70	$1,761.77