Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $338.31 / $2,145.57 / $5,487.15	Facility		$338.31	$2,145.57	$5,487.15
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $90.16 / $90.16 / $169.16	Facility	52	$90.16	$90.16	$169.16
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $46.28 / $97.79 / $196.04	Facility	53	$46.28	$97.79	$196.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $172.59 / $279.57 / $650.00	Professional		$172.59	$279.57	$650.00
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $36.06 / $90.30 / $191.15	Professional	53	$36.06	$90.30	$191.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.94 / $269.64 / $657.35	Professional		$169.94	$269.64	$657.35
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $85.12 / $125.87 / $135.06	Professional	53	$85.12	$125.87	$135.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $503.36 / $553.69 / $939.60	Facility		$503.36	$553.69	$939.60
BCBS Facility/Professional Professional Modifier Low / Median / High Price $303.35 / $505.70 / $916.34	Professional		$303.35	$505.70	$916.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $453.24 / $569.54 / $948.75	Facility		$453.24	$569.54	$948.75
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $194.94 / $194.94 / $194.94	Facility	52	$194.94	$194.94	$194.94
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $48.74 / $48.74 / $48.74	Facility	53	$48.74	$48.74	$48.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $301.75 / $301.75 / $454.60	Professional		$301.75	$301.75	$454.60
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $133.21 / $170.55 / $246.00	Professional	53	$133.21	$170.55	$246.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $180.32 / $344.09 / $564.84	Facility		$180.32	$344.09	$564.84
Medcost Facility/Professional Professional Modifier Low / Median / High Price $389.80 / $530.00 / $635.00	Professional		$389.80	$530.00	$635.00
Medcost Facility/Professional Professional Modifier 53 Low / Median / High Price $411.40 / $411.40 / $478.20	Professional	53	$411.40	$411.40	$478.20
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,225.21 / $1,278.65 / $1,917.71	Facility		$1,225.21	$1,278.65	$1,917.71
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $130.28 / $283.11 / $590.19	Professional		$130.28	$283.11	$590.19
United Facility/Professional Facility Modifier Low / Median / High Price $226.00 / $475.00 / $2,909.00	Facility		$226.00	$475.00	$2,909.00
United Facility/Professional Professional Modifier Low / Median / High Price $313.45 / $444.53 / $912.21	Professional		$313.45	$444.53	$912.21
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $1,040.30 / $1,040.30 / $16,394.00	Facility		$1,040.30	$1,040.30	$16,394.00
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $717.55 / $717.55 / $717.55	Facility	52	$717.55	$717.55	$717.55
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $179.39 / $179.39 / $179.39	Facility	53	$179.39	$179.39	$179.39
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,182.76 / $2,208.13 / $2,840.70	Professional		$1,182.76	$2,208.13	$2,840.70