Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $297.89 / $509.47 / $7,278.00	Facility		$297.89	$509.47	$7,278.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $724.71 / $1,443.80 / $1,443.80	Facility	50	$724.71	$1,443.80	$1,443.80
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $223.42 / $240.53 / $382.10	Facility	54	$223.42	$240.53	$382.10
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $44.68 / $48.11 / $76.42	Facility	55	$44.68	$48.11	$76.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $269.14 / $320.70 / $541.62	Professional		$269.14	$320.70	$541.62
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $408.12 / $565.88 / $1,389.27	Professional	50	$408.12	$565.88	$1,389.27
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $223.42 / $240.53 / $361.26	Professional	54	$223.42	$240.53	$361.26
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $43.57 / $48.11 / $68.45	Professional	55	$43.57	$48.11	$68.45
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $281.14 / $309.26 / $446.39	Professional		$281.14	$309.26	$446.39
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $421.72 / $451.38 / $836.19	Professional	50	$421.72	$451.38	$836.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.43 / $377.89 / $743.66	Professional		$217.43	$377.89	$743.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $260.55 / $379.68 / $888.89	Professional		$260.55	$379.68	$888.89
Medcost Facility/Professional Facility Modifier Low / Median / High Price $297.89 / $336.58 / $727.70	Facility		$297.89	$336.58	$727.70
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $434.51 / $466.83 / $1,777.50	Facility	50	$434.51	$466.83	$1,777.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $378.85 / $407.00 / $407.00	Professional		$378.85	$407.00	$407.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $568.28 / $568.28 / $568.28	Professional	50	$568.28	$568.28	$568.28
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $340.31 / $415.77 / $521.19	Professional		$340.31	$415.77	$521.19
United Facility/Professional Facility Modifier Low / Median / High Price $905.00 / $2,417.00 / $4,102.00	Facility		$905.00	$2,417.00	$4,102.00
United Facility/Professional Professional Modifier Low / Median / High Price $257.52 / $339.24 / $888.99	Professional		$257.52	$339.24	$888.99
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $1,765.45 / $1,765.45 / $16,394.00	Facility		$1,765.45	$1,765.45	$16,394.00
Wellcare Facility/Professional Facility Modifier 54 Low / Median / High Price $1,117.09 / $1,117.09 / $1,117.09	Facility	54	$1,117.09	$1,117.09	$1,117.09
Wellcare Facility/Professional Facility Modifier 55 Low / Median / High Price $239.38 / $239.38 / $239.38	Facility	55	$239.38	$239.38	$239.38
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,245.28 / $2,559.67 / $2,743.50	Professional		$2,245.28	$2,559.67	$2,743.50