Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $891.66 / $2,821.00 / $9,477.00	Facility		$891.66	$2,821.00	$9,477.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $145.69 / $172.60 / $189.86	Facility	53	$145.69	$172.60	$189.86
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $546.39 / $647.24 / $711.96	Facility	54	$546.39	$647.24	$711.96
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $109.28 / $129.44 / $142.38	Facility	55	$109.28	$129.44	$142.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $423.26 / $658.61 / $832.83	Professional		$423.26	$658.61	$832.83
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $211.63 / $364.26 / $474.64	Professional	52	$211.63	$364.26	$474.64
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $317.45 / $546.39 / $711.96	Professional	54	$317.45	$546.39	$711.96
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $63.49 / $109.28 / $142.38	Professional	55	$63.49	$109.28	$142.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $558.88 / $798.40 / $995.11	Professional		$558.88	$798.40	$995.11
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 $576.47 / $762.98 / $847.75	Professional		$576.47	$762.98	$847.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $623.29 / $623.29 / $623.29	Facility		$623.29	$623.29	$623.29
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 $400.31 / $943.32 / $1,399.68	Professional		$400.31	$943.32	$1,399.68
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $620.63 / $943.41 / $1,144.38	Professional		$620.63	$943.41	$1,144.38
United Facility/Professional Facility Modifier Low / Median / High Price $980.00 / $2,052.00 / $4,333.39	Facility		$980.00	$2,052.00	$4,333.39
United Facility/Professional Professional Modifier Low / Median / High Price $475.90 / $717.50 / $1,086.00	Professional		$475.90	$717.50	$1,086.00