Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $724.00 / $2,817.00 / $6,930.00	Facility		$724.00	$2,817.00	$6,930.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $74.42 / $99.23 / $158.91	Facility	52	$74.42	$99.23	$158.91
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $30.13 / $63.56 / $119.93	Facility	53	$30.13	$63.56	$119.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $165.30 / $297.67 / $572.47	Professional		$165.30	$297.67	$572.47
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $35.63 / $78.73 / $177.65	Professional	53	$35.63	$78.73	$177.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $234.81 / $354.16	Professional		$173.78	$234.81	$354.16
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $173.53 / $173.53 / $173.53	Professional	53	$173.53	$173.53	$173.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.26 / $487.89 / $2,213.00	Facility		$243.26	$487.89	$2,213.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $194.61 / $194.61 / $194.61	Facility	52	$194.61	$194.61	$194.61
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.65 / $48.65 / $916.34	Facility	53	$48.65	$48.65	$916.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $301.45 / $301.45	Professional		$301.45	$301.45	$301.45
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $40.79 / $94.49 / $245.51	Professional	53	$40.79	$94.49	$245.51
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $456.88 / $2,204.00 / $6,116.00	Facility		$456.88	$2,204.00	$6,116.00
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $170.51 / $341.01 / $414.08	Professional		$170.51	$341.01	$414.08
Florida Blue Facility/Professional Professional Modifier 53 Low / Median / High Price $57.29 / $120.45 / $189.94	Professional	53	$57.29	$120.45	$189.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $145.77 / $240.85 / $404.21	Professional		$145.77	$240.85	$404.21
United Facility/Professional Facility Modifier Low / Median / High Price $390.00 / $2,491.00 / $5,015.00	Facility		$390.00	$2,491.00	$5,015.00
United Facility/Professional Professional Modifier Low / Median / High Price $267.29 / $373.96 / $662.47	Professional		$267.29	$373.96	$662.47
United Facility/Professional Professional Modifier 53 Low / Median / High Price $92.98 / $92.98 / $92.98	Professional	53	$92.98	$92.98	$92.98
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.29 / $279.66 / $279.66	Professional		$151.29	$279.66	$279.66
Wellpoint Facility/Professional Professional Modifier 53 Low / Median / High Price $75.64 / $139.69 / $139.69	Professional	53	$75.64	$139.69	$139.69