Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.94 / $1,664.24 / $3,497.00	Facility		$242.94	$1,664.24	$3,497.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $524.77 / $3,586.50 / $4,828.50	Facility	50	$524.77	$3,586.50	$4,828.50
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $21.74 / $35.47 / $67.13	Facility	53	$21.74	$35.47	$67.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $234.77 / $632.27	Professional		$95.09	$234.77	$632.27
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.52 / $141.52 / $191.19	Professional	22	$141.52	$141.52	$191.19
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.41 / $364.43 / $1,039.57	Professional	50	$154.41	$364.43	$1,039.57
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $21.74 / $45.66 / $82.17	Professional	53	$21.74	$45.66	$82.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $181.17 / $246.89 / $571.62	Professional		$181.17	$246.89	$571.62
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $259.20 / $665.55 / $857.43	Professional	50	$259.20	$665.55	$857.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $155.13 / $400.44 / $663.64	Professional		$155.13	$400.44	$663.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $395.75 / $395.75 / $820.28	Facility		$395.75	$395.75	$820.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.72 / $275.62 / $586.79	Professional		$128.72	$275.62	$586.79
Medcost Facility/Professional Facility Modifier Low / Median / High Price $108.71 / $291.54 / $506.76	Facility		$108.71	$291.54	$506.76
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $368.53 / $584.58 / $784.50	Facility	50	$368.53	$584.58	$784.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $269.00 / $269.00 / $400.00	Professional		$269.00	$269.00	$400.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $493.38 / $493.38 / $493.38	Professional	50	$493.38	$493.38	$493.38
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,217.57 / $1,217.57 / $1,217.57	Facility		$1,217.57	$1,217.57	$1,217.57
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $156.78 / $221.85 / $418.75	Professional		$156.78	$221.85	$418.75
United Facility/Professional Facility Modifier Low / Median / High Price $554.00 / $2,417.00 / $4,102.00	Facility		$554.00	$2,417.00	$4,102.00
United Facility/Professional Professional Modifier Low / Median / High Price $206.45 / $318.32 / $603.89	Professional		$206.45	$318.32	$603.89
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $422.14 / $554.14 / $32,000.00	Facility		$422.14	$554.14	$32,000.00
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $57.80 / $110.83 / $110.83	Facility	53	$57.80	$110.83	$110.83
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,052.00 / $4,050.50 / $4,050.50	Professional		$1,052.00	$4,050.50	$4,050.50