Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.00 / $732.00 / $732.00	Facility		$30.00	$732.00	$732.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $540.00	Professional		$30.00	$30.00	$540.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $66.76 / $66.76 / $66.76	Professional	QX	$66.76	$66.76	$66.76
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $120.54 / $390.00 / $455.00	Professional	QZ	$120.54	$390.00	$455.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $250.00 / $375.00 / $590.00	Professional		$250.00	$375.00	$590.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,740.00 / $1,950.00 / $3,990.00	Facility		$1,740.00	$1,950.00	$3,990.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $330.00 / $330.00 / $330.00	Professional		$330.00	$330.00	$330.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $19.63 / $37.59	Professional		$5.00	$19.63	$37.59
United Facility/Professional Professional Modifier Low / Median / High Price $40.00 / $68.00 / $102.00	Professional		$40.00	$68.00	$102.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $82.00 / $82.00 / $82.00	Facility		$82.00	$82.00	$82.00
Wellcare Facility/Professional Facility Modifier QK Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QK	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QX Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QX	$37.00	$37.00	$39.50
Wellcare Facility/Professional Facility Modifier QY Low / Median / High Price $37.00 / $37.00 / $39.50	Facility	QY	$37.00	$37.00	$39.50
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,351.68 / $2,880.00 / $2,880.00	Professional		$1,351.68	$2,880.00	$2,880.00