Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $256.50 / $388.87 / $653.00	Facility		$256.50	$388.87	$653.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $238.48 / $249.08 / $377.66	Facility	54	$238.48	$249.08	$377.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $241.69 / $337.04 / $758.78	Professional		$241.69	$337.04	$758.78
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,076.01 / $1,076.01 / $1,076.01	Professional	50	$1,076.01	$1,076.01	$1,076.01
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $238.48 / $250.51 / $465.98	Professional	54	$238.48	$250.51	$465.98
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $274.13 / $384.11 / $464.10	Professional		$274.13	$384.11	$464.10
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 $302.04 / $467.27 / $811.67	Professional		$302.04	$467.27	$811.67
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 $279.80 / $425.67 / $794.01	Professional		$279.80	$425.67	$794.01
Medcost Facility/Professional Facility Modifier Low / Median / High Price $317.97 / $381.92 / $584.51	Facility		$317.97	$381.92	$584.51
Medcost Facility/Professional Professional Modifier Low / Median / High Price $334.49 / $404.00 / $460.00	Professional		$334.49	$404.00	$460.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $501.74 / $501.74 / $501.74	Professional	50	$501.74	$501.74	$501.74
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $475.40 / $525.83 / $648.52	Professional		$475.40	$525.83	$648.52
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 $265.58 / $377.28 / $796.22	Professional		$265.58	$377.28	$796.22
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,788.33 / $1,788.33	Facility		$55.00	$1,788.33	$1,788.33
Wellcare Facility/Professional Facility Modifier 54 Low / Median / High Price $617.27 / $1,251.83 / $1,251.83	Facility	54	$617.27	$1,251.83	$1,251.83
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $2,459.67 / $2,564.64 / $3,042.60	Professional		$2,459.67	$2,564.64	$3,042.60