Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $769.00 / $6,024.00 / $12,444.00	Facility		$769.00	$6,024.00	$12,444.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $100.94 / $100.94 / $113.92	Facility	53	$100.94	$100.94	$113.92
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $378.53 / $378.53 / $427.19	Facility	54	$378.53	$378.53	$427.19
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $75.70 / $75.70 / $85.44	Facility	55	$75.70	$75.70	$85.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $504.71 / $609.66 / $861.60	Professional		$504.71	$609.66	$861.60
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $75.70 / $95.58 / $129.24	Professional	55	$75.70	$95.58	$129.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $422.08 / $669.33 / $1,106.21	Professional		$422.08	$669.33	$1,106.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $323.00 / $3,747.54 / $4,461.35	Facility		$323.00	$3,747.54	$4,461.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $514.65 / $833.33 / $1,368.78	Professional		$514.65	$833.33	$1,368.78
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $5,558.00 / $12,685.00 / $23,031.00	Facility		$5,558.00	$12,685.00	$23,031.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $295.70 / $485.44 / $780.24	Professional		$295.70	$485.44	$780.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.55 / $469.27 / $894.65	Professional		$77.55	$469.27	$894.65
United Facility/Professional Facility Modifier Low / Median / High Price $3,320.00 / $10,309.00 / $15,888.00	Facility		$3,320.00	$10,309.00	$15,888.00
United Facility/Professional Professional Modifier Low / Median / High Price $506.38 / $689.24 / $1,149.47	Professional		$506.38	$689.24	$1,149.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $560.41 / $560.41 / $560.41	Professional		$560.41	$560.41	$560.41