Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $287.62 / $453.87 / $1,615.00	Facility		$287.62	$453.87	$1,615.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $232.97 / $245.73 / $376.20	Facility	54	$232.97	$245.73	$376.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $273.88 / $327.64 / $669.12	Professional		$273.88	$327.64	$669.12
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $353.61 / $353.61 / $478.98	Professional		$353.61	$353.61	$478.98
BCBS Facility/Professional Professional Modifier Low / Median / High Price $319.32 / $493.57 / $842.56	Professional		$319.32	$493.57	$842.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $221.28 / $221.28 / $606.10	Facility		$221.28	$221.28	$606.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $317.07 / $441.52 / $791.99	Professional		$317.07	$441.52	$791.99
Medcost Facility/Professional Facility Modifier Low / Median / High Price $310.62 / $393.17 / $626.07	Facility		$310.62	$393.17	$626.07
Medcost Facility/Professional Professional Modifier Low / Median / High Price $371.92 / $403.00 / $451.00	Professional		$371.92	$403.00	$451.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $463.15 / $538.61 / $641.04	Professional		$463.15	$538.61	$641.04
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 $272.83 / $380.25 / $892.15	Professional		$272.83	$380.25	$892.15
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,901.20 / $1,901.20	Facility		$55.00	$1,901.20	$1,901.20
Wellcare Facility/Professional Facility Modifier 54 Low / Median / High Price $597.77 / $1,207.74 / $1,207.74	Facility	54	$597.77	$1,207.74	$1,207.74
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,388.16 / $2,519.36 / $2,993.40	Professional		$2,388.16	$2,519.36	$2,993.40