Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,207.19 / $5,432.12 / $9,228.39	Facility		$1,207.19	$5,432.12	$9,228.39
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,377.48 / $5,928.14 / $6,892.80	Facility	50	$2,377.48	$5,928.14	$6,892.80
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $119.86 / $232.12 / $241.44	Facility	53	$119.86	$232.12	$241.44
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $449.48 / $870.44 / $905.39	Facility	54	$449.48	$870.44	$905.39
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $89.90 / $174.09 / $181.08	Facility	55	$89.90	$174.09	$181.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $507.67 / $658.61 / $1,313.26	Professional		$507.67	$658.61	$1,313.26
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $269.33 / $341.19 / $580.29	Professional	52	$269.33	$341.19	$580.29
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $404.01 / $513.71 / $1,014.18	Professional	54	$404.01	$513.71	$1,014.18
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $76.15 / $97.36 / $174.09	Professional	55	$76.15	$97.36	$174.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $469.74 / $491.82 / $688.55	Professional		$469.74	$491.82	$688.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,019.39 / $5,859.32 / $12,779.92	Facility		$3,019.39	$5,859.32	$12,779.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $613.41 / $891.74 / $1,054.66	Professional		$613.41	$891.74	$1,054.66
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 $533.73 / $821.47 / $1,251.83	Professional		$533.73	$821.47	$1,251.83
Hally Health Facility/Professional Professional Modifier Low / Median / High Price $505.10 / $872.20 / $3,082.19	Professional		$505.10	$872.20	$3,082.19
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 $647.91 / $656.63 / $711.95	Professional		$647.91	$656.63	$711.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $744.80	Professional		$32.34	$32.34	$744.80
United Facility/Professional Facility Modifier Low / Median / High Price $1,282.00 / $3,751.00 / $6,625.00	Facility		$1,282.00	$3,751.00	$6,625.00
United Facility/Professional Professional Modifier Low / Median / High Price $587.79 / $852.94 / $1,376.18	Professional		$587.79	$852.94	$1,376.18