Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.82 / $570.47 / $1,350.00	Facility		$91.82	$570.47	$1,350.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $596.20 / $1,127.60 / $2,896.17	Facility	50	$596.20	$1,127.60	$2,896.17
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $22.12 / $36.43 / $252.26	Facility	52	$22.12	$36.43	$252.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.23 / $69.70 / $185.14	Professional		$44.23	$69.70	$185.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $64.11 / $94.77 / $296.94	Professional	50	$64.11	$94.77	$296.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $57.44 / $82.79 / $105.54	Professional		$57.44	$82.79	$105.54
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $86.16 / $127.38 / $158.31	Professional	50	$86.16	$127.38	$158.31
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.17 / $108.74 / $169.90	Professional		$61.17	$108.74	$169.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.74 / $57.74 / $395.75	Facility		$57.74	$57.74	$395.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.24 / $85.45 / $139.62	Professional		$56.24	$85.45	$139.62
Medcost Facility/Professional Facility Modifier Low / Median / High Price $45.56 / $79.00 / $127.03	Facility		$45.56	$79.00	$127.03
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $90.00 / $139.61 / $214.18	Facility	50	$90.00	$139.61	$214.18
Medcost Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $75.00 / $93.07	Professional		$75.00	$75.00	$93.07
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $139.61 / $139.61 / $139.61	Professional	50	$139.61	$139.61	$139.61
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $747.23 / $794.05 / $1,164.80	Facility		$747.23	$794.05	$1,164.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $62.30 / $82.31 / $113.94	Professional		$62.30	$82.31	$113.94
United Facility/Professional Facility Modifier Low / Median / High Price $117.00 / $896.00 / $2,229.00	Facility		$117.00	$896.00	$2,229.00
United Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $77.48 / $149.28	Professional		$54.90	$77.48	$149.28
United Facility/Professional Professional Modifier 50 Low / Median / High Price $80.00 / $80.00 / $85.00	Professional	50	$80.00	$80.00	$85.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $122.05 / $220.97 / $15,000.00	Facility		$122.05	$220.97	$15,000.00
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $91.53 / $176.78 / $176.78	Facility	52	$91.53	$176.78	$176.78
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $325.76 / $468.88 / $550.50	Professional		$325.76	$468.88	$550.50