Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $5,342.40 / $8,644.27	Facility		$1,000.00	$5,342.40	$8,644.27
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $587.47 / $587.47 / $587.47	Facility	54	$587.47	$587.47	$587.47
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $117.49 / $117.49 / $117.49	Facility	55	$117.49	$117.49	$117.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $783.29 / $912.60 / $1,916.89	Professional		$783.29	$912.60	$1,916.89
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $587.47 / $876.50 / $2,967.35	Professional	54	$587.47	$876.50	$2,967.35
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $117.49 / $175.30 / $593.47	Professional	55	$117.49	$175.30	$593.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.59 / $346.59 / $693.19	Professional		$346.59	$346.59	$693.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,455.73 / $8,503.52 / $13,195.43	Facility		$2,455.73	$8,503.52	$13,195.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $732.50 / $872.72 / $1,653.32	Professional		$732.50	$872.72	$1,653.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $6,300.00 / $6,300.00 / $6,300.00	Facility		$6,300.00	$6,300.00	$6,300.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $624.04 / $1,248.24 / $1,619.79	Professional		$624.04	$1,248.24	$1,619.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $1,042.60 / $1,407.52	Professional		$32.34	$1,042.60	$1,407.52
Providence Facility/Professional Facility Modifier Low / Median / High Price $936.14 / $1,285.52 / $2,948.75	Facility		$936.14	$1,285.52	$2,948.75
Providence Facility/Professional Professional Modifier Low / Median / High Price $624.04 / $1,282.68 / $1,776.73	Professional		$624.04	$1,282.68	$1,776.73
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $1,103.86 / $1,103.86 / $1,127.83	Professional	54	$1,103.86	$1,103.86	$1,127.83
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $275.97 / $275.97 / $281.95	Professional	55	$275.97	$275.97	$281.95
United Facility/Professional Facility Modifier Low / Median / High Price $639.00 / $5,971.00 / $8,422.00	Facility		$639.00	$5,971.00	$8,422.00
United Facility/Professional Professional Modifier Low / Median / High Price $996.40 / $1,211.29 / $1,669.79	Professional		$996.40	$1,211.29	$1,669.79