Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $883.51 / $6,962.00 / $27,955.65	Facility		$883.51	$6,962.00	$27,955.65
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $317.39 / $404.42 / $578.64	Facility	52	$317.39	$404.42	$578.64
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $126.96 / $161.77 / $231.45	Facility	53	$126.96	$161.77	$231.45
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,731.00 / $24,910.00 / $73,118.00	Facility		$5,731.00	$24,910.00	$73,118.00
CDPHP Facility/Professional Facility Modifier Low / Median / High Price $922.80 / $5,064.50 / $15,193.50	Facility		$922.80	$5,064.50	$15,193.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $12,886.00 / $30,055.00 / $45,917.00	Facility		$12,886.00	$30,055.00	$45,917.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $575.63 / $575.63 / $575.63	Facility	52	$575.63	$575.63	$575.63
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $143.91 / $143.91 / $143.91	Facility	53	$143.91	$143.91	$143.91
Emblem Health Facility/Professional Facility Modifier Low / Median / High Price $332.00 / $939.00 / $3,812.34	Facility		$332.00	$939.00	$3,812.34
MVP Health Care Facility/Professional Facility Modifier Low / Median / High Price $11,209.00 / $29,328.00 / $45,917.00	Facility		$11,209.00	$29,328.00	$45,917.00
MVP Health Care Facility/Professional Facility Modifier 52 Low / Median / High Price $575.63 / $575.63 / $575.63	Facility	52	$575.63	$575.63	$575.63
MVP Health Care Facility/Professional Facility Modifier 53 Low / Median / High Price $143.91 / $143.91 / $143.91	Facility	53	$143.91	$143.91	$143.91
United Facility/Professional Facility Modifier Low / Median / High Price $2,444.00 / $13,478.00 / $40,704.00	Facility		$2,444.00	$13,478.00	$40,704.00
Univera Facility/Professional Facility Modifier Low / Median / High Price $878.41 / $878.41 / $2,121.03	Facility		$878.41	$878.41	$2,121.03