Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $344.23 / $2,094.40 / $5,283.00	Facility		$344.23	$2,094.40	$5,283.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $84.18 / $103.69 / $172.12	Facility	52	$84.18	$103.69	$172.12
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $84.32 / $139.54 / $258.16	Facility	53	$84.32	$139.54	$258.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $171.13 / $303.64 / $666.11	Professional		$171.13	$303.64	$666.11
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $36.59 / $84.32 / $174.80	Professional	53	$36.59	$84.32	$174.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $174.72 / $222.68 / $274.14	Professional		$174.72	$222.68	$274.14
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $67.08 / $107.83 / $118.14	Professional	53	$67.08	$107.83	$118.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.35 / $317.25 / $476.52	Professional		$212.35	$317.25	$476.52
Anthem BCBS Facility/Professional Professional Modifier 53 Low / Median / High Price $84.66 / $143.13 / $256.14	Professional	53	$84.66	$143.13	$256.14
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 $301.75 / $301.75 / $312.37	Professional		$301.75	$301.75	$312.37
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $133.43 / $144.07 / $268.16	Professional	53	$133.43	$144.07	$268.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $178.45 / $344.60 / $1,065.09	Facility		$178.45	$344.60	$1,065.09
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $664.86 / $664.86 / $664.86	Facility	52	$664.86	$664.86	$664.86
Medica Facility/Professional Facility Modifier 53 Low / Median / High Price $166.21 / $166.21 / $166.21	Facility	53	$166.21	$166.21	$166.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $327.99 / $618.02 / $2,208.13	Professional		$327.99	$618.02	$2,208.13
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $260.91 / $260.91 / $517.07	Professional		$260.91	$260.91	$517.07
Qualchoice Facility/Professional Professional Modifier 53 Low / Median / High Price $77.14 / $77.14 / $144.24	Professional	53	$77.14	$77.14	$144.24
United Facility/Professional Facility Modifier Low / Median / High Price $1,103.00 / $1,751.00 / $2,539.00	Facility		$1,103.00	$1,751.00	$2,539.00
United Facility/Professional Professional Modifier Low / Median / High Price $317.81 / $533.24 / $806.76	Professional		$317.81	$533.24	$806.76