Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $576.62 / $937.60 / $5,449.00	Facility		$576.62	$937.60	$5,449.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $432.47 / $499.42 / $788.60	Facility	54	$432.47	$499.42	$788.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $519.63 / $665.89 / $973.75	Professional		$519.63	$665.89	$973.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,128.89 / $2,128.89 / $2,128.89	Professional	50	$2,128.89	$2,128.89	$2,128.89
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $432.47 / $499.42 / $663.69	Professional	54	$432.47	$499.42	$663.69
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $86.49 / $99.88 / $132.74	Professional	55	$86.49	$99.88	$132.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,149.79 / $1,149.79 / $1,149.79	Professional		$1,149.79	$1,149.79	$1,149.79
BCBS Facility/Professional Professional Modifier Low / Median / High Price $553.44 / $802.88 / $1,528.61	Professional		$553.44	$802.88	$1,528.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $540.76 / $765.55 / $1,737.38	Professional		$540.76	$765.55	$1,737.38
Medcost Facility/Professional Facility Modifier Low / Median / High Price $576.62 / $687.00 / $1,043.83	Facility		$576.62	$687.00	$1,043.83
Medcost Facility/Professional Professional Modifier Low / Median / High Price $784.80 / $838.00 / $838.00	Professional		$784.80	$838.00	$838.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $1,177.20 / $1,177.20 / $1,177.20	Professional	50	$1,177.20	$1,177.20	$1,177.20
United Facility/Professional Facility Modifier Low / Median / High Price $1,728.00 / $3,733.00 / $6,543.00	Facility		$1,728.00	$3,733.00	$6,543.00
United Facility/Professional Professional Modifier Low / Median / High Price $533.33 / $686.85 / $1,582.85	Professional		$533.33	$686.85	$1,582.85
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $4,117.62 / $4,117.62 / $12,000.00	Facility		$4,117.62	$4,117.62	$12,000.00
Wellcare Facility/Professional Facility Modifier 54 Low / Median / High Price $2,152.54 / $2,152.54 / $2,152.54	Facility	54	$2,152.54	$2,152.54	$2,152.54
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $4,370.96 / $5,003.20 / $5,720.33	Professional		$4,370.96	$5,003.20	$5,720.33