Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $10,000.00 / $23,442.29	Facility		$2,884.03	$10,000.00	$23,442.29
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $7,413.10 / $7,413.10 / $7,413.10	Facility	22	$7,413.10	$7,413.10	$7,413.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $10,964.78 / $10,964.78 / $47,863.01	Facility	50	$10,964.78	$10,964.78	$47,863.01
Aetna Facility/Professional Facility Modifier AS Low / Median / High Price $13,489.63 / $13,489.63 / $13,489.63	Facility	AS	$13,489.63	$13,489.63	$13,489.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $549.54 / $1,905.46 / $9,120.11	Professional		$549.54	$1,905.46	$9,120.11
Aetna Facility/Professional Professional Modifier AS Low / Median / High Price $162.18 / $323.59 / $870.96	Professional	AS	$162.18	$323.59	$870.96
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $1,348.96 / $2,137.96	Professional		$181.97	$1,348.96	$2,137.96
Ambetter Facility/Professional Professional Modifier AS Low / Median / High Price $190.55 / $190.55 / $190.55	Professional	AS	$190.55	$190.55	$190.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $19,498.45 / $19,498.45 / $19,498.45	Facility		$19,498.45	$19,498.45	$19,498.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,548.82 / $2,754.23 / $3,715.35	Professional		$1,548.82	$2,754.23	$3,715.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $602.56 / $602.56 / $602.56	Facility		$602.56	$602.56	$602.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,905.46 / $3,388.44	Professional		$1,380.38	$1,905.46	$3,388.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $2,398.83 / $2,398.83 / $2,951.21	Professional		$2,398.83	$2,398.83	$2,951.21
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,258.93 / $1,778.28 / $2,884.03	Facility		$1,258.93	$1,778.28	$2,884.03
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,819.70 / $1,995.26 / $2,630.27	Professional		$1,819.70	$1,995.26	$2,630.27
United Facility/Professional Facility Modifier Low / Median / High Price $9,549.93 / $21,379.62 / $28,840.32	Facility		$9,549.93	$21,379.62	$28,840.32
United Facility/Professional Professional Modifier Low / Median / High Price $1,148.15 / $1,548.82 / $2,818.38	Professional		$1,148.15	$1,548.82	$2,818.38
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $25,118.86 / $53,703.18 / $53,703.18	Facility		$25,118.86	$53,703.18	$53,703.18
Wellcare Facility/Professional Facility Modifier 54 Low / Median / High Price $37,153.52 / $37,153.52 / $37,153.52	Facility	54	$37,153.52	$37,153.52	$37,153.52
Wellcare Facility/Professional Facility Modifier 62 Low / Median / High Price $33,884.42 / $33,884.42 / $33,884.42	Facility	62	$33,884.42	$33,884.42	$33,884.42
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $5,370.32 / $5,370.32 / $5,370.32	Facility	AS	$5,370.32	$5,370.32	$5,370.32
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $13,489.63 / $13,489.63 / $13,489.63	Professional		$13,489.63	$13,489.63	$13,489.63