Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.16 / $319.50 / $1,615.00	Facility		$137.16	$319.50	$1,615.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $90.59 / $102.87 / $168.98	Facility	54	$90.59	$102.87	$168.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $120.78 / $139.72 / $281.30	Professional		$120.78	$139.72	$281.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.96 / $147.96 / $147.96	Professional		$147.96	$147.96	$147.96
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 $135.04 / $202.56 / $366.97	Professional		$135.04	$202.56	$366.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.76 / $173.76 / $606.10	Facility		$173.76	$173.76	$606.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $132.44 / $182.95 / $327.24	Professional		$132.44	$182.95	$327.24
Medcost Facility/Professional Facility Modifier Low / Median / High Price $120.78 / $164.59 / $260.94	Facility		$120.78	$164.59	$260.94
Medcost Facility/Professional Professional Modifier Low / Median / High Price $162.69 / $181.00 / $191.00	Professional		$162.69	$181.00	$191.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $181.78 / $208.53 / $258.60	Professional		$181.78	$208.53	$258.60
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 $118.80 / $175.37 / $384.22	Professional		$118.80	$175.37	$384.22
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $681.25 / $681.25	Facility		$55.00	$681.25	$681.25
Wellcare Facility/Professional Facility Modifier 54 Low / Median / High Price $236.96 / $476.87 / $476.87	Facility	54	$236.96	$476.87	$476.87
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $943.20 / $1,069.59 / $1,251.98	Professional		$943.20	$1,069.59	$1,251.98