Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.96 / $175.45 / $5,300.89	Facility		$51.96	$175.45	$5,300.89
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $96.71 / $201.54 / $3,155.57	Facility	50	$96.71	$201.54	$3,155.57
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $18.02 / $25.98 / $64.88	Facility	52	$18.02	$25.98	$64.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $54.60 / $130.05	Professional		$33.61	$54.60	$130.05
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $76.69 / $165.43 / $302.06	Professional	50	$76.69	$165.43	$302.06
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $16.17 / $23.07 / $36.90	Professional	52	$16.17	$23.07	$36.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $27.28 / $45.42 / $66.98	Professional		$27.28	$45.42	$66.98
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $66.05 / $72.65 / $95.00	Professional	50	$66.05	$72.65	$95.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.27 / $150.69 / $263.14	Facility		$73.27	$150.69	$263.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.85 / $44.03 / $80.33	Professional		$29.85	$44.03	$80.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.29 / $58.66 / $95.38	Professional		$38.29	$58.66	$95.38
Medcost Facility/Professional Facility Modifier Low / Median / High Price $36.04 / $58.29 / $88.91	Facility		$36.04	$58.29	$88.91
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $67.05 / $90.89 / $132.07	Facility	50	$67.05	$90.89	$132.07
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.53 / $30.53 / $30.53	Professional		$30.53	$30.53	$30.53
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $45.80 / $45.80 / $45.80	Professional	50	$45.80	$45.80	$45.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $75.30 / $118.77	Professional		$54.90	$75.30	$118.77
United Facility/Professional Facility Modifier Low / Median / High Price $225.00 / $1,221.00 / $3,585.00	Facility		$225.00	$1,221.00	$3,585.00
United Facility/Professional Professional Modifier Low / Median / High Price $44.17 / $64.34 / $125.40	Professional		$44.17	$64.34	$125.40