Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $524.81 / $3,630.78 / $8,511.38	Facility		$524.81	$3,630.78	$8,511.38
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $741.31 / $870.96 / $1,995.26	Facility	50	$741.31	$870.96	$1,995.26
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $676.08 / $676.08 / $676.08	Facility	54	$676.08	$676.08	$676.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $446.68 / $1,380.38	Professional		$295.12	$446.68	$1,380.38
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $346.74 / $724.44 / $2,344.23	Professional	50	$346.74	$724.44	$2,344.23
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $288.40 / $512.86 / $912.01	Professional	54	$288.40	$512.86	$912.01
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $63.10 / $63.10 / $389.05	Professional	55	$63.10	$63.10	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $295.12 / $575.44	Professional		$177.83	$295.12	$575.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $295.12 / $295.12 / $489.78	Professional	50	$295.12	$295.12	$489.78
Ambetter Facility/Professional Professional Modifier 55 Low / Median / High Price $109.65 / $109.65 / $109.65	Professional	55	$109.65	$109.65	$109.65
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,513.56 / $2,951.21	Facility		$1,148.15	$1,513.56	$2,951.21
BCBS Facility/Professional Professional Modifier Low / Median / High Price $288.40 / $489.78 / $660.69	Professional		$288.40	$489.78	$660.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $645.65 / $776.25 / $977.24	Professional		$645.65	$776.25	$977.24
Medica Facility/Professional Facility Modifier Low / Median / High Price $288.40 / $549.54 / $1,819.70	Facility		$288.40	$549.54	$1,819.70
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,862.09 / $1,862.09 / $1,862.09	Facility	50	$1,862.09	$1,862.09	$1,862.09
Medica Facility/Professional Facility Modifier 54 Low / Median / High Price $977.24 / $977.24 / $977.24	Facility	54	$977.24	$977.24	$977.24
Medica Facility/Professional Facility Modifier 55 Low / Median / High Price $208.93 / $208.93 / $208.93	Facility	55	$208.93	$208.93	$208.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $676.08 / $954.99	Professional		$467.74	$676.08	$954.99
Medica Facility/Professional Professional Modifier 50 Low / Median / High Price $501.19 / $891.25 / $1,148.15	Professional	50	$501.19	$891.25	$1,148.15
Medica Facility/Professional Professional Modifier 54 Low / Median / High Price $489.78 / $537.03 / $630.96	Professional	54	$489.78	$537.03	$630.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $724.44 / $758.58 / $1,000.00	Professional		$724.44	$758.58	$1,000.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $457.09 / $457.09	Facility		$457.09	$457.09	$457.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $691.83 / $741.31 / $933.25	Professional		$691.83	$741.31	$933.25
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $794.33 / $794.33 / $794.33	Facility		$794.33	$794.33	$794.33
United Facility/Professional Facility Modifier Low / Median / High Price $676.08 / $1,819.70 / $6,309.57	Facility		$676.08	$1,819.70	$6,309.57
United Facility/Professional Professional Modifier Low / Median / High Price $380.19 / $630.96 / $794.33	Professional		$380.19	$630.96	$794.33