Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $436.88 / $2,074.00 / $8,265.32	Facility		$436.88	$2,074.00	$8,265.32
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $3,457.50 / $6,125.08 / $13,824.05	Facility	50	$3,457.50	$6,125.08	$13,824.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $312.06 / $1,398.80 / $2,785.48	Professional		$312.06	$1,398.80	$2,785.48
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $548.03 / $1,557.00 / $3,147.14	Professional	50	$548.03	$1,557.00	$3,147.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.21 / $144.21 / $288.41	Professional		$144.21	$144.21	$288.41
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $388.44 / $388.44 / $592.28	Professional	50	$388.44	$388.44	$592.28
BCBS Facility/Professional Professional Modifier Low / Median / High Price $620.02 / $2,353.46 / $3,949.45	Professional		$620.02	$2,353.46	$3,949.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $558.72 / $558.72 / $558.72	Facility		$558.72	$558.72	$558.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $399.62 / $1,257.46 / $3,951.33	Professional		$399.62	$1,257.46	$3,951.33
Medcost Facility/Professional Facility Modifier Low / Median / High Price $312.06 / $1,742.52 / $2,842.19	Facility		$312.06	$1,742.52	$2,842.19
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $1,038.83 / $3,088.91 / $5,074.64	Facility	50	$1,038.83	$3,088.91	$5,074.64
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,849.00 / $1,849.00 / $2,550.92	Professional		$1,849.00	$1,849.00	$2,550.92
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $3,088.91 / $3,088.91 / $8,744.29	Professional	50	$3,088.91	$3,088.91	$8,744.29
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $416.46 / $749.42 / $3,580.82	Professional		$416.46	$749.42	$3,580.82
United Facility/Professional Facility Modifier Low / Median / High Price $2,606.00 / $14,893.00 / $22,265.00	Facility		$2,606.00	$14,893.00	$22,265.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,537.90 / $2,345.30 / $4,229.22	Professional		$1,537.90	$2,345.30	$4,229.22
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $3,084.78 / $3,084.78	Facility		$55.00	$3,084.78	$3,084.78
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $6,263.82 / $11,741.92 / $14,060.18	Professional		$6,263.82	$11,741.92	$14,060.18