Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,263.19 / $7,567.08 / $13,841.56	Facility		$2,263.19	$7,567.08	$13,841.56
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $100.88 / $100.88 / $100.88	Facility	53	$100.88	$100.88	$100.88
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $378.29 / $378.29 / $378.29	Facility	54	$378.29	$378.29	$378.29
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $75.66 / $75.66 / $75.66	Facility	55	$75.66	$75.66	$75.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $200.12 / $667.11 / $1,628.78	Professional		$200.12	$667.11	$1,628.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $730.91 / $2,144.29 / $4,329.68	Professional	50	$730.91	$2,144.29	$4,329.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $252.19 / $419.01 / $1,443.23	Professional	52	$252.19	$419.01	$1,443.23
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $378.29 / $628.51 / $1,093.39	Professional	54	$378.29	$628.51	$1,093.39
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $7.85 / $75.66 / $432.97	Professional	55	$7.85	$75.66	$432.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $453.16 / $922.60 / $1,187.28	Professional		$453.16	$922.60	$1,187.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $3,007.90 / $3,924.55 / $7,652.58	Facility		$3,007.90	$3,924.55	$7,652.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $487.89 / $831.64 / $1,108.85	Professional		$487.89	$831.64	$1,108.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,821.47 / $1,821.47 / $1,821.47	Facility		$1,821.47	$1,821.47	$1,821.47
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,059.10 / $1,243.44 / $1,641.42	Professional		$1,059.10	$1,243.44	$1,641.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $857.45 / $2,493.19 / $6,887.55	Facility		$857.45	$2,493.19	$6,887.55
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $4,609.20 / $4,609.20 / $4,609.20	Facility	50	$4,609.20	$4,609.20	$4,609.20
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $1,305.69 / $1,305.69 / $1,305.69	Facility	53	$1,305.69	$1,305.69	$1,305.69
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $4,569.92 / $4,569.92 / $4,569.92	Facility	54	$4,569.92	$4,569.92	$4,569.92
Medica Facility/Professional Facility Modifier 55 Low / Median / High Price $979.27 / $979.27 / $979.27	Facility	55	$979.27	$979.27	$979.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $622.66 / $1,079.73 / $1,452.89	Professional		$622.66	$1,079.73	$1,452.89
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $1,554.72 / $1,770.38 / $1,810.62	Professional	50	$1,554.72	$1,770.38	$1,810.62
Medica Facility/Professional Professional Modifier 54 Low / Median / High Price $775.54 / $839.97 / $1,010.90	Professional	54	$775.54	$839.97	$1,010.90
Midlands Facility/Professional Facility Modifier Low / Median / High Price $1,016.73 / $1,641.42 / $2,333.00	Facility		$1,016.73	$1,641.42	$2,333.00
Midlands Facility/Professional Professional Modifier Low / Median / High Price $983.58 / $1,286.60 / $1,616.88	Professional		$983.58	$1,286.60	$1,616.88
United Facility/Professional Facility Modifier Low / Median / High Price $3,711.00 / $5,356.00 / $7,772.00	Facility		$3,711.00	$5,356.00	$7,772.00
United Facility/Professional Professional Modifier Low / Median / High Price $825.55 / $1,209.22 / $1,527.40	Professional		$825.55	$1,209.22	$1,527.40