Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,200.00 / $4,833.00 / $16,400.00	Facility		$1,200.00	$4,833.00	$16,400.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $147.97 / $147.97 / $147.97	Facility	53	$147.97	$147.97	$147.97
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $554.90 / $554.90 / $554.90	Facility	54	$554.90	$554.90	$554.90
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $110.98 / $110.98 / $110.98	Facility	55	$110.98	$110.98	$110.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $682.10 / $739.87 / $744.95	Professional		$682.10	$739.87	$744.95
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $110.02 / $110.02 / $111.74	Professional	55	$110.02	$110.02	$111.74
BCBS Facility/Professional Facility Modifier Low / Median / High Price $4,128.70 / $6,530.17 / $10,314.52	Facility		$4,128.70	$6,530.17	$10,314.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $645.04 / $806.68 / $885.75	Professional		$645.04	$806.68	$885.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $3,921.86 / $3,921.86 / $3,921.86	Facility		$3,921.86	$3,921.86	$3,921.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $625.89 / $880.59 / $1,144.75	Professional		$625.89	$880.59	$1,144.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $660.14 / $3,948.00 / $9,412.67	Facility		$660.14	$3,948.00	$9,412.67
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $4,042.62 / $4,042.62 / $4,042.62	Facility	53	$4,042.62	$4,042.62	$4,042.62
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $14,149.17 / $14,149.17 / $14,149.17	Facility	54	$14,149.17	$14,149.17	$14,149.17
Medica Facility/Professional Facility Modifier 55 Low / Median / High Price $3,031.96 / $3,031.96 / $3,031.96	Facility	55	$3,031.96	$3,031.96	$3,031.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $591.60 / $733.18 / $1,046.75	Professional		$591.60	$733.18	$1,046.75
United Facility/Professional Facility Modifier Low / Median / High Price $1,624.00 / $6,140.00 / $10,376.00	Facility		$1,624.00	$6,140.00	$10,376.00
United Facility/Professional Professional Modifier Low / Median / High Price $570.22 / $747.36 / $948.00	Professional		$570.22	$747.36	$948.00