Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $368.28 / $3,324.50 / $5,357.78	Facility		$368.28	$3,324.50	$5,357.78
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $97.71 / $127.77 / $161.08	Facility	52	$97.71	$127.77	$161.08
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $39.08 / $51.11 / $64.43	Facility	53	$39.08	$51.11	$64.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $453.24 / $842.52 / $1,675.01	Facility		$453.24	$842.52	$1,675.01
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $176.57 / $176.57 / $176.57	Facility	52	$176.57	$176.57	$176.57
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $44.14 / $44.14 / $44.14	Facility	53	$44.14	$44.14	$44.14
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $137.94 / $137.94 / $137.94	Facility	62	$137.94	$137.94	$137.94
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $22.07 / $22.07 / $22.07	Facility	AS	$22.07	$22.07	$22.07
Medcost Facility/Professional Facility Modifier Low / Median / High Price $195.42 / $326.58 / $540.00	Facility		$195.42	$326.58	$540.00
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $65.00 / $78.56 / $114.67	Facility	80	$65.00	$78.56	$114.67
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $31.73 / $53.76 / $75.59	Facility	AS	$31.73	$53.76	$75.59
United Facility/Professional Facility Modifier Low / Median / High Price $393.00 / $650.00 / $4,824.00	Facility		$393.00	$650.00	$4,824.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $1,095.54 / $4,901.45 / $16,394.00	Facility		$1,095.54	$4,901.45	$16,394.00
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $358.02 / $3,716.72 / $3,716.72	Facility	52	$358.02	$3,716.72	$3,716.72
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $89.50 / $929.18 / $929.18	Facility	53	$89.50	$929.18	$929.18
Wellcare Facility/Professional Facility Modifier 62 Low / Median / High Price $279.70 / $2,903.69 / $2,903.69	Facility	62	$279.70	$2,903.69	$2,903.69
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $44.75 / $464.59 / $464.59	Facility	AS	$44.75	$464.59	$464.59