Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,559.60 / $6,187.17 / $11,814.15	Facility		$1,559.60	$6,187.17	$11,814.15
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $135.19 / $135.19 / $345.95	Facility	53	$135.19	$135.19	$345.95
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $506.96 / $506.96 / $1,297.30	Facility	54	$506.96	$506.96	$1,297.30
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $101.39 / $101.39 / $259.45	Facility	55	$101.39	$101.39	$259.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $512.09 / $675.95 / $1,207.45	Professional		$512.09	$675.95	$1,207.45
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $260.83 / $337.98 / $384.38	Professional	52	$260.83	$337.98	$384.38
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $391.26 / $506.96 / $612.99	Professional	54	$391.26	$506.96	$612.99
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $78.25 / $101.39 / $127.21	Professional	55	$78.25	$101.39	$127.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $460.66 / $532.48 / $1,009.03	Professional		$460.66	$532.48	$1,009.03
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $798.72 / $798.72 / $798.72	Professional	50	$798.72	$798.72	$798.72
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,945.64 / $4,225.25 / $9,265.87	Facility		$1,945.64	$4,225.25	$9,265.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $515.14 / $1,021.00 / $1,816.07	Professional		$515.14	$1,021.00	$1,816.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,115.00 / $1,115.00 / $1,985.43	Facility		$1,115.00	$1,115.00	$1,985.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $594.59 / $834.19 / $1,514.24	Professional		$594.59	$834.19	$1,514.24
Medcost Facility/Professional Facility Modifier Low / Median / High Price $554.79 / $845.92 / $1,663.70	Facility		$554.79	$845.92	$1,663.70
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $1,017.00 / $1,332.00 / $2,700.00	Facility	50	$1,017.00	$1,332.00	$2,700.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,444.00 / $1,444.00 / $1,675.17	Professional		$1,444.00	$1,444.00	$1,675.17
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $2,512.76 / $2,512.76 / $2,512.76	Professional	50	$2,512.76	$2,512.76	$2,512.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.42 / $356.85 / $586.93	Professional		$69.42	$356.85	$586.93
United Facility/Professional Facility Modifier Low / Median / High Price $1,981.00 / $10,147.00 / $16,816.00	Facility		$1,981.00	$10,147.00	$16,816.00
United Facility/Professional Professional Modifier Low / Median / High Price $501.82 / $677.31 / $1,412.84	Professional		$501.82	$677.31	$1,412.84