Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.33 / $338.10 / $5,134.88	Facility		$122.33	$338.10	$5,134.88
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $31.32 / $50.43 / $84.81	Facility	52	$31.32	$50.43	$84.81
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $12.53 / $26.61 / $443.84	Facility	53	$12.53	$26.61	$443.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $112.43 / $252.00	Professional		$69.73	$112.43	$252.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $31.32 / $50.43 / $100.38	Professional	52	$31.32	$50.43	$100.38
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $12.53 / $22.30 / $48.81	Professional	53	$12.53	$22.30	$48.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.67 / $130.83 / $135.91	Professional		$74.67	$130.83	$135.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.93 / $176.51 / $273.97	Professional		$111.93	$176.51	$273.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.67 / $144.30 / $263.48	Professional		$95.67	$144.30	$263.48
Medcost Facility/Professional Facility Modifier Low / Median / High Price $62.64 / $138.00 / $208.75	Facility		$62.64	$138.00	$208.75
Medcost Facility/Professional Professional Modifier Low / Median / High Price $138.38 / $138.38 / $244.63	Professional		$138.38	$138.38	$244.63
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $3.00 / $116.30 / $268.70	Professional		$3.00	$116.30	$268.70
United Facility/Professional Facility Modifier Low / Median / High Price $361.00 / $896.00 / $2,229.00	Facility		$361.00	$896.00	$2,229.00
United Facility/Professional Professional Modifier Low / Median / High Price $95.95 / $153.43 / $274.20	Professional		$95.95	$153.43	$274.20
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $303.00 / $303.00	Facility		$55.00	$303.00	$303.00
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $242.40 / $242.40 / $242.40	Facility	52	$242.40	$242.40	$242.40
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $60.60 / $60.60 / $60.60	Facility	53	$60.60	$60.60	$60.60
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $452.72 / $719.92 / $845.55	Professional		$452.72	$719.92	$845.55