Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.84 / $2,630.27 / $7,762.47	Facility		$338.84	$2,630.27	$7,762.47
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $93.33 / $125.89 / $239.88	Facility	53	$93.33	$125.89	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $302.00 / $676.08	Professional		$169.82	$302.00	$676.08
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $64.57 / $120.23 / $218.78	Professional	53	$64.57	$120.23	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $181.97 / $316.23	Professional		$158.49	$181.97	$316.23
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	53	$144.54	$144.54	$144.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $645.65 / $1,412.54 / $2,884.03	Facility		$645.65	$1,412.54	$2,884.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $389.05 / $691.83	Professional		$169.82	$389.05	$691.83
BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $83.18 / $123.03 / $213.80	Professional	53	$83.18	$123.03	$213.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $371.54 / $549.54 / $794.33	Facility		$371.54	$549.54	$794.33
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $446.68 / $446.68 / $446.68	Facility	22	$446.68	$446.68	$446.68
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	52	$295.12	$295.12	$295.12
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $74.13 / $74.13 / $74.13	Facility	53	$74.13	$74.13	$74.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $346.74	Professional		$302.00	$302.00	$346.74
Medcost Facility/Professional Professional Modifier Low / Median / High Price $562.34 / $562.34 / $602.56	Professional		$562.34	$562.34	$602.56
Medcost Facility/Professional Professional Modifier 53 Low / Median / High Price $181.97 / $181.97 / $194.98	Professional	53	$181.97	$181.97	$194.98
Medcost Facility/Professional Facility Modifier Low / Median / High Price $181.97 / $338.84 / $630.96	Facility		$181.97	$338.84	$630.96
Medcost Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $302.00 / $302.00	Professional		$302.00	$302.00	$302.00
Medcost Facility/Professional Professional Modifier 53 Low / Median / High Price $478.63 / $478.63 / $478.63	Professional	53	$478.63	$478.63	$478.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $3,715.35 / $7,762.47	Facility		$457.09	$3,715.35	$7,762.47
United Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $316.23 / $602.56	Professional		$173.78	$316.23	$602.56