Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $872.61 / $5,695.21 / $9,561.00	Facility		$872.61	$5,695.21	$9,561.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $968.38 / $2,131.19 / $6,270.76	Facility	50	$968.38	$2,131.19	$6,270.76
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $104.34 / $135.25 / $199.31	Facility	53	$104.34	$135.25	$199.31
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $391.26 / $507.18 / $747.41	Facility	54	$391.26	$507.18	$747.41
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $78.25 / $101.44 / $149.47	Facility	55	$78.25	$101.44	$149.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $507.67 / $658.61 / $1,482.35	Professional		$507.67	$658.61	$1,482.35
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $775.55 / $775.55 / $775.55	Professional	50	$775.55	$775.55	$775.55
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $254.64 / $260.83 / $409.30	Professional	52	$254.64	$260.83	$409.30
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $381.95 / $413.05 / $845.12	Professional	54	$381.95	$413.05	$845.12
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $76.39 / $89.90 / $419.89	Professional	55	$76.39	$89.90	$419.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $346.73 / $495.33 / $794.26	Professional		$346.73	$495.33	$794.26
BCBS Facility/Professional Professional Modifier Low / Median / High Price $319.05 / $900.54 / $1,992.89	Professional		$319.05	$900.54	$1,992.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $569.28 / $827.26 / $1,729.04	Professional		$569.28	$827.26	$1,729.04
Medcost Facility/Professional Facility Modifier Low / Median / High Price $521.67 / $888.00 / $1,800.00	Facility		$521.67	$888.00	$1,800.00
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $933.00 / $1,366.59 / $3,442.50	Facility	50	$933.00	$1,366.59	$3,442.50
Medcost Facility/Professional Professional Modifier Low / Median / High Price $791.00 / $791.00 / $911.06	Professional		$791.00	$791.00	$911.06
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $1,366.59 / $1,366.59 / $1,366.59	Professional	50	$1,366.59	$1,366.59	$1,366.59
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $3,013.85 / $3,146.08 / $5,190.27	Facility		$3,013.85	$3,146.08	$5,190.27
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $575.04 / $650.25 / $848.20	Professional		$575.04	$650.25	$848.20
United Facility/Professional Facility Modifier Low / Median / High Price $2,353.00 / $6,575.00 / $9,616.00	Facility		$2,353.00	$6,575.00	$9,616.00
United Facility/Professional Professional Modifier Low / Median / High Price $510.83 / $690.41 / $1,401.74	Professional		$510.83	$690.41	$1,401.74
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $2,459.19 / $6,887.55 / $26,542.00	Facility		$2,459.19	$6,887.55	$26,542.00
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $250.20 / $281.10 / $1,305.69	Facility	53	$250.20	$281.10	$1,305.69
Wellcare Facility/Professional Facility Modifier 54 Low / Median / High Price $875.69 / $983.84 / $4,569.92	Facility	54	$875.69	$983.84	$4,569.92
Wellcare Facility/Professional Facility Modifier 55 Low / Median / High Price $187.65 / $210.82 / $979.27	Facility	55	$187.65	$210.82	$979.27
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $5,762.00 / $6,276.56 / $6,276.56	Professional		$5,762.00	$6,276.56	$6,276.56