Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $789.00 / $2,857.65 / $6,590.00	Facility		$789.00	$2,857.65	$6,590.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $74.61 / $106.14 / $159.50	Facility	52	$74.61	$106.14	$159.50
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $30.20 / $64.33 / $120.56	Facility	53	$30.20	$64.33	$120.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.13 / $303.64 / $590.14	Professional		$171.13	$303.64	$590.14
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $35.86 / $80.61 / $179.61	Professional	53	$35.86	$80.61	$179.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.06 / $230.56 / $354.97	Professional		$174.06	$230.56	$354.97
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $69.08 / $90.53 / $161.07	Professional	53	$69.08	$90.53	$161.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $243.68 / $488.86 / $2,213.00	Facility		$243.68	$488.86	$2,213.00
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $194.94 / $194.94 / $194.94	Facility	52	$194.94	$194.94	$194.94
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.74 / $48.74 / $917.76	Facility	53	$48.74	$48.74	$917.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.75 / $301.75 / $301.75	Professional		$301.75	$301.75	$301.75
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $40.79 / $94.17 / $246.00	Professional	53	$40.79	$94.17	$246.00
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 / $423.93	Professional		$170.51	$341.01	$423.93
Florida Blue Facility/Professional Professional Modifier 53 Low / Median / High Price $57.29 / $120.80 / $192.33	Professional	53	$57.29	$120.80	$192.33
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 $264.04 / $373.48 / $675.42	Professional		$264.04	$373.48	$675.42
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 $151.56 / $279.93 / $279.93	Professional		$151.56	$279.93	$279.93
Wellpoint Facility/Professional Professional Modifier 53 Low / Median / High Price $75.92 / $139.97 / $139.97	Professional	53	$75.92	$139.97	$139.97