Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $260.95 / $468.92 / $1,089.04	Facility		$260.95	$468.92	$1,089.04
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $145.77 / $161.03 / $242.34	Facility	52	$145.77	$161.03	$242.34
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $218.66 / $241.54 / $363.50	Facility	54	$218.66	$241.54	$363.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $254.15 / $322.05 / $598.42	Professional		$254.15	$322.05	$598.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $623.27 / $623.27 / $623.27	Professional		$623.27	$623.27	$623.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.89 / $115.89 / $117.58	Facility		$115.89	$115.89	$117.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $297.95 / $467.98 / $814.66	Professional		$297.95	$467.98	$814.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $221.28 / $221.28 / $395.75	Facility		$221.28	$221.28	$395.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $298.42 / $413.72 / $765.19	Professional		$298.42	$413.72	$765.19
Medcost Facility/Professional Facility Modifier Low / Median / High Price $291.54 / $379.00 / $609.00	Facility		$291.54	$379.00	$609.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $352.53 / $387.00 / $449.00	Professional		$352.53	$387.00	$449.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $439.61 / $517.00 / $728.01	Professional		$439.61	$517.00	$728.01
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 $265.04 / $381.00 / $752.51	Professional		$265.04	$381.00	$752.51
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $802.91 / $1,606.45 / $12,000.00	Facility		$802.91	$1,606.45	$12,000.00
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $642.33 / $1,285.16 / $1,285.16	Facility	52	$642.33	$1,285.16	$1,285.16
Wellcare Facility/Professional Facility Modifier 54 Low / Median / High Price $562.04 / $1,124.51 / $1,124.51	Facility	54	$562.04	$1,124.51	$1,124.51
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,258.80 / $2,506.96 / $2,983.35	Professional		$2,258.80	$2,506.96	$2,983.35