Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $578.00 / $2,686.79 / $5,944.60	Facility		$578.00	$2,686.79	$5,944.60
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $90.02 / $236.14 / $432.47	Facility	52	$90.02	$236.14	$432.47
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $59.67 / $129.27 / $236.75	Facility	53	$59.67	$129.27	$236.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.03 / $338.04 / $745.50	Professional		$180.03	$338.04	$745.50
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $42.21 / $100.54 / $235.78	Professional	53	$42.21	$100.54	$235.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $153.16 / $294.54 / $657.35	Professional		$153.16	$294.54	$657.35
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $43.44 / $125.87 / $319.29	Professional	53	$43.44	$125.87	$319.29
BCBS Facility/Professional Professional Modifier Low / Median / High Price $302.95 / $608.14 / $960.28	Professional		$302.95	$608.14	$960.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $453.24 / $569.54 / $948.75	Facility		$453.24	$569.54	$948.75
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $248.66 / $248.66 / $248.66	Facility	52	$248.66	$248.66	$248.66
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $62.17 / $62.17 / $62.17	Facility	53	$62.17	$62.17	$62.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $238.38 / $425.61 / $748.53	Professional		$238.38	$425.61	$748.53
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $116.81 / $152.43 / $218.37	Professional	53	$116.81	$152.43	$218.37
Medcost Facility/Professional Facility Modifier Low / Median / High Price $182.87 / $439.45 / $646.79	Facility		$182.87	$439.45	$646.79
Medcost Facility/Professional Professional Modifier Low / Median / High Price $425.26 / $530.00 / $690.00	Professional		$425.26	$530.00	$690.00
Medcost Facility/Professional Professional Modifier 53 Low / Median / High Price $411.40 / $411.40 / $478.20	Professional	53	$411.40	$411.40	$478.20
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,225.21 / $1,240.36 / $2,814.84	Facility		$1,225.21	$1,240.36	$2,814.84
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $129.94 / $281.77 / $590.19	Professional		$129.94	$281.77	$590.19
United Facility/Professional Facility Modifier Low / Median / High Price $393.00 / $650.00 / $4,824.00	Facility		$393.00	$650.00	$4,824.00
United Facility/Professional Professional Modifier Low / Median / High Price $287.27 / $422.84 / $870.93	Professional		$287.27	$422.84	$870.93
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $1,038.84 / $1,038.84 / $16,394.00	Facility		$1,038.84	$1,038.84	$16,394.00
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $716.72 / $716.72 / $716.72	Facility	52	$716.72	$716.72	$716.72
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $179.18 / $179.18 / $179.18	Facility	53	$179.18	$179.18	$179.18
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,345.00 / $2,836.73 / $2,852.81	Professional		$1,345.00	$2,836.73	$2,852.81