Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $930.78 / $3,463.20 / $8,644.27	Facility		$930.78	$3,463.20	$8,644.27
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,096.95 / $4,328.24 / $5,244.60	Facility	50	$3,096.95	$4,328.24	$5,244.60
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $114.33 / $114.33 / $114.33	Facility	53	$114.33	$114.33	$114.33
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $428.74 / $428.74 / $428.74	Facility	54	$428.74	$428.74	$428.74
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $85.75 / $85.75 / $85.75	Facility	55	$85.75	$85.75	$85.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $506.77 / $658.61 / $2,753.15	Professional		$506.77	$658.61	$2,753.15
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $4,329.68 / $4,329.68 / $4,329.68	Professional	50	$4,329.68	$4,329.68	$4,329.68
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $285.83 / $426.19 / $1,443.23	Professional	52	$285.83	$426.19	$1,443.23
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $232.91 / $639.28 / $2,164.85	Professional	54	$232.91	$639.28	$2,164.85
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $85.75 / $127.86 / $432.97	Professional	55	$85.75	$127.86	$432.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $505.93 / $505.93 / $505.93	Professional		$505.93	$505.93	$505.93
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 $582.37 / $636.28 / $906.44	Professional		$582.37	$636.28	$906.44
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 $500.71 / $909.98 / $1,252.60	Professional		$500.71	$909.98	$1,252.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $760.15 / $1,026.20	Professional		$32.34	$760.15	$1,026.20
Providence Facility/Professional Facility Modifier Low / Median / High Price $670.68 / $918.72 / $2,481.50	Facility		$670.68	$918.72	$2,481.50
Providence Facility/Professional Professional Modifier Low / Median / High Price $500.71 / $935.53 / $1,280.06	Professional		$500.71	$935.53	$1,280.06
Providence Facility/Professional Professional Modifier 54 Low / Median / High Price $805.89 / $805.89 / $821.94	Professional	54	$805.89	$805.89	$821.94
Providence Facility/Professional Professional Modifier 55 Low / Median / High Price $201.47 / $201.47 / $205.49	Professional	55	$201.47	$201.47	$205.49
United Facility/Professional Facility Modifier Low / Median / High Price $1,229.00 / $6,210.00 / $7,158.00	Facility		$1,229.00	$6,210.00	$7,158.00
United Facility/Professional Professional Modifier Low / Median / High Price $726.14 / $896.09 / $1,201.74	Professional		$726.14	$896.09	$1,201.74