Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $124.96 / $3,277.84 / $4,665.10	Facility		$124.96	$3,277.84	$4,665.10
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,614.90 / $4,287.28 / $11,788.14	Facility	50	$2,614.90	$4,287.28	$11,788.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $148.32 / $405.97 / $1,027.52	Professional	50	$148.32	$405.97	$1,027.52
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $158.81 / $284.62 / $284.62	Professional	50	$158.81	$284.62	$284.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $205.09 / $205.09 / $205.09	Facility		$205.09	$205.09	$205.09
Medcost Facility/Professional Facility Modifier Low / Median / High Price $115.17 / $288.27 / $462.32	Facility		$115.17	$288.27	$462.32
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $334.65 / $495.56 / $814.13	Facility	50	$334.65	$495.56	$814.13
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $495.56 / $495.56 / $1,266.83	Professional	50	$495.56	$495.56	$1,266.83
United Facility/Professional Facility Modifier Low / Median / High Price $116.00 / $874.00 / $2,074.00	Facility		$116.00	$874.00	$2,074.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $564.67 / $564.67	Facility		$55.00	$564.67	$564.67