Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $580.41 / $1,729.75 / $6,519.00	Facility		$580.41	$1,729.75	$6,519.00
Aetna Facility/Professional Facility Modifier 22 Low / Median / High Price $1,001.22 / $1,001.22 / $1,001.22	Facility	22	$1,001.22	$1,001.22	$1,001.22
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $124.30 / $226.75 / $1,491.75	Facility	52	$124.30	$226.75	$1,491.75
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $49.72 / $89.54 / $131.49	Facility	53	$49.72	$89.54	$131.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $237.27 / $435.39 / $979.54	Professional		$237.27	$435.39	$979.54
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $49.72 / $90.70 / $153.04	Professional	53	$49.72	$90.70	$153.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $210.35 / $443.68 / $885.48	Professional		$210.35	$443.68	$885.48
BCBS Facility/Professional Facility Modifier Low / Median / High Price $567.09 / $623.79 / $1,058.57	Facility		$567.09	$623.79	$1,058.57
BCBS Facility/Professional Professional Modifier Low / Median / High Price $416.09 / $804.85 / $1,364.74	Professional		$416.09	$804.85	$1,364.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $453.24 / $685.00 / $1,226.89	Facility		$453.24	$685.00	$1,226.89
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $341.33 / $341.33 / $341.33	Facility	52	$341.33	$341.33	$341.33
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $85.33 / $85.33 / $85.33	Facility	53	$85.33	$85.33	$85.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $333.71 / $573.36 / $1,006.16	Professional		$333.71	$573.36	$1,006.16
Medcost Facility/Professional Facility Modifier Low / Median / High Price $256.06 / $595.98 / $863.49	Facility		$256.06	$595.98	$863.49
Medcost Facility/Professional Professional Modifier Low / Median / High Price $486.00 / $534.00 / $708.93	Professional		$486.00	$534.00	$708.93
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,576.25 / $1,645.40 / $1,915.73	Facility		$1,576.25	$1,645.40	$1,915.73
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $285.55 / $590.46 / $1,032.22	Professional		$285.55	$590.46	$1,032.22
United Facility/Professional Facility Modifier Low / Median / High Price $400.00 / $1,064.00 / $4,877.00	Facility		$400.00	$1,064.00	$4,877.00
United Facility/Professional Professional Modifier Low / Median / High Price $421.55 / $569.09 / $1,162.24	Professional		$421.55	$569.09	$1,162.24
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $1,425.30 / $1,425.30 / $16,394.00	Facility		$1,425.30	$1,425.30	$16,394.00
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $982.11 / $982.11 / $982.11	Facility	52	$982.11	$982.11	$982.11
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $245.53 / $245.53 / $245.53	Facility	53	$245.53	$245.53	$245.53
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,906.00 / $3,552.73 / $3,762.00	Professional		$1,906.00	$3,552.73	$3,762.00