Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $212.28 / $1,860.90 / $5,449.00	Facility		$212.28	$1,860.90	$5,449.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $41.43 / $96.31 / $180.78	Facility	52	$41.43	$96.31	$180.78
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $16.57 / $38.52 / $72.31	Facility	53	$16.57	$38.52	$72.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.73 / $164.16 / $433.73	Professional		$68.73	$164.16	$433.73
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $83.61 / $107.76 / $396.85	Professional		$83.61	$107.76	$396.85
BCBS Facility/Professional Professional Modifier Low / Median / High Price $172.39 / $399.58 / $617.62	Professional		$172.39	$399.58	$617.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $135.24 / $280.82 / $494.16	Professional		$135.24	$280.82	$494.16
Medcost Facility/Professional Facility Modifier Low / Median / High Price $87.06 / $254.74 / $484.80	Facility		$87.06	$254.74	$484.80
Medcost Facility/Professional Professional Modifier Low / Median / High Price $295.55 / $295.55 / $295.55	Professional		$295.55	$295.55	$295.55
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $118.99 / $298.06 / $413.10	Professional		$118.99	$298.06	$413.10
United Facility/Professional Facility Modifier Low / Median / High Price $905.00 / $2,417.00 / $4,102.00	Facility		$905.00	$2,417.00	$4,102.00
United Facility/Professional Professional Modifier Low / Median / High Price $219.42 / $340.83 / $595.09	Professional		$219.42	$340.83	$595.09
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $471.85 / $471.85 / $12,000.00	Facility		$471.85	$471.85	$12,000.00
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $319.13 / $319.13 / $319.13	Facility	52	$319.13	$319.13	$319.13
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $79.78 / $79.78 / $79.78	Facility	53	$79.78	$79.78	$79.78
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,374.00 / $1,989.58 / $1,989.58	Professional		$1,374.00	$1,989.58	$1,989.58