Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $200.51 / $313.04 / $1,350.00	Facility		$200.51	$313.04	$1,350.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $150.38 / $159.77 / $254.14	Facility	54	$150.38	$159.77	$254.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $178.40 / $214.94 / $485.71	Professional		$178.40	$214.94	$485.71
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $150.38 / $159.77 / $294.83	Professional	54	$150.38	$159.77	$294.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $197.69 / $205.96 / $284.83	Professional		$197.69	$205.96	$284.83
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $423.35 / $423.35 / $423.35	Professional	54	$423.35	$423.35	$423.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.52 / $312.14 / $568.97	Professional		$213.52	$312.14	$568.97
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 $210.44 / $292.75 / $531.76	Professional		$210.44	$292.75	$531.76
Medcost Facility/Professional Facility Modifier Low / Median / High Price $200.51 / $258.25 / $428.70	Facility		$200.51	$258.25	$428.70
Medcost Facility/Professional Professional Modifier Low / Median / High Price $247.24 / $272.00 / $291.00	Professional		$247.24	$272.00	$291.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $299.70 / $330.66 / $395.39	Professional		$299.70	$330.66	$395.39
United Facility/Professional Facility Modifier Low / Median / High Price $182.66 / $874.00 / $2,074.00	Facility		$182.66	$874.00	$2,074.00
United Facility/Professional Professional Modifier Low / Median / High Price $180.80 / $257.30 / $574.15	Professional		$180.80	$257.30	$574.15
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $1,110.50 / $1,110.50	Facility		$55.00	$1,110.50	$1,110.50
Wellcare Facility/Professional Facility Modifier 54 Low / Median / High Price $387.30 / $777.35 / $777.35	Facility	54	$387.30	$777.35	$777.35
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,543.44 / $1,634.08 / $1,909.88	Professional		$1,543.44	$1,634.08	$1,909.88