Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $407.38 / $1,737.80 / $3,467.37	Facility		$407.38	$1,737.80	$3,467.37
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $524.81 / $3,467.37 / $5,128.61	Facility	50	$524.81	$3,467.37	$5,128.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $239.88 / $851.14	Professional		$104.71	$239.88	$851.14
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $141.25 / $478.63 / $1,548.82	Professional	22	$141.25	$478.63	$1,548.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $158.49 / $371.54 / $1,202.26	Professional	50	$158.49	$371.54	$1,202.26
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $63.10 / $138.04 / $186.21	Professional	53	$63.10	$138.04	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $181.97 / $380.19	Professional		$95.50	$181.97	$380.19
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $141.25 / $275.42 / $691.83	Professional	50	$141.25	$275.42	$691.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $380.19 / $630.96	Professional		$144.54	$380.19	$630.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $398.11 / $398.11	Facility		$398.11	$398.11	$398.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $263.03 / $562.34	Professional		$125.89	$263.03	$562.34
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $128.82 / $128.82 / $128.82	Professional	53	$128.82	$128.82	$128.82
Medcost Facility/Professional Professional Modifier Low / Median / High Price $588.84 / $588.84 / $588.84	Professional		$588.84	$588.84	$588.84
Medcost Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $245.47 / $489.78	Facility		$112.20	$245.47	$489.78
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Facility		$2,691.53	$2,691.53	$2,691.53
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $380.19 / $512.86	Professional		$158.49	$380.19	$512.86
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $2,137.96 / $4,073.80	Facility		$676.08	$2,137.96	$4,073.80
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $208.93 / $446.68	Professional		$100.00	$208.93	$446.68
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $32,359.37	Facility		$2,691.53	$2,691.53	$32,359.37
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $537.03 / $537.03 / $537.03	Facility	53	$537.03	$537.03	$537.03
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $4,073.80 / $4,073.80 / $4,073.80	Professional		$4,073.80	$4,073.80	$4,073.80