Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $116.79 / $278.39 / $1,245.00	Facility		$116.79	$278.39	$1,245.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $86.63 / $87.59 / $144.30	Facility	54	$86.63	$87.59	$144.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $106.14 / $122.72 / $239.19	Professional		$106.14	$122.72	$239.19
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $86.63 / $92.58 / $167.15	Professional	54	$86.63	$92.58	$167.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $148.44 / $148.44 / $184.57	Professional		$148.44	$148.44	$184.57
Ambetter Facility/Professional Professional Modifier 54 Low / Median / High Price $88.33 / $88.33 / $250.33	Professional	54	$88.33	$88.33	$250.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.40 / $184.58 / $334.31	Professional		$129.40	$184.58	$334.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $137.68 / $137.68 / $606.10	Facility		$137.68	$137.68	$606.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.62 / $171.98 / $304.80	Professional		$122.62	$171.98	$304.80
Medcost Facility/Professional Facility Modifier Low / Median / High Price $115.51 / $144.72 / $233.00	Facility		$115.51	$144.72	$233.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $141.04 / $154.00 / $163.00	Professional		$141.04	$154.00	$163.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $167.20 / $193.43 / $220.91	Professional		$167.20	$193.43	$220.91
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 $100.89 / $147.08 / $318.27	Professional		$100.89	$147.08	$318.27
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $578.48 / $2,165.76	Facility		$55.00	$578.48	$2,165.76
Wellcare Facility/Professional Facility Modifier 54 Low / Median / High Price $181.50 / $229.42 / $402.69	Facility	54	$181.50	$229.42	$402.69
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $913.28 / $913.28 / $1,064.09	Professional		$913.28	$913.28	$1,064.09