Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $312.97 / $2,125.00 / $5,343.38	Facility		$312.97	$2,125.00	$5,343.38
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $84.03 / $103.50 / $171.95	Facility	52	$84.03	$103.50	$171.95
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $84.03 / $139.05 / $257.67	Facility	53	$84.03	$139.05	$257.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.93 / $302.22 / $735.52	Professional		$169.93	$302.22	$735.52
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $37.01 / $84.03 / $190.75	Professional	53	$37.01	$84.03	$190.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.16 / $202.48 / $416.68	Professional		$173.16	$202.48	$416.68
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $107.60 / $107.60 / $107.60	Professional	53	$107.60	$107.60	$107.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.35 / $317.25 / $452.00	Professional		$212.35	$317.25	$452.00
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $84.35 / $142.58 / $255.60	Professional	53	$84.35	$142.58	$255.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,213.00 / $2,213.00 / $2,213.00	Facility		$2,213.00	$2,213.00	$2,213.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.45 / $301.45 / $312.06	Professional		$301.45	$301.45	$312.06
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $132.94 / $143.54 / $267.63	Professional	53	$132.94	$143.54	$267.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $178.14 / $343.90 / $1,063.59	Facility		$178.14	$343.90	$1,063.59
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $663.66 / $663.66 / $663.66	Facility	52	$663.66	$663.66	$663.66
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $165.92 / $165.92 / $165.92	Facility	53	$165.92	$165.92	$165.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $332.54 / $628.30 / $2,206.53	Professional		$332.54	$628.30	$2,206.53
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $260.91 / $260.91 / $287.70	Professional		$260.91	$260.91	$287.70
United Facility/Professional Facility Modifier Low / Median / High Price $899.00 / $1,729.00 / $2,539.00	Facility		$899.00	$1,729.00	$2,539.00
United Facility/Professional Professional Modifier Low / Median / High Price $314.24 / $508.88 / $857.96	Professional		$314.24	$508.88	$857.96