Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $767.79 / $793.58 / $6,892.82	Facility		$767.79	$793.58	$6,892.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $767.79 / $2,522.96 / $9,109.65	Professional		$767.79	$2,522.96	$9,109.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $239.17 / $337.58 / $337.58	Professional		$239.17	$337.58	$337.58
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $1,012.74 / $1,012.74 / $1,142.14	Professional	50	$1,012.74	$1,012.74	$1,142.14
BCBS Facility/Professional Professional Modifier Low / Median / High Price $847.42 / $3,638.05 / $12,182.13	Professional		$847.42	$3,638.05	$12,182.13
Medcost Facility/Professional Facility Modifier Low / Median / High Price $595.48 / $6,290.89 / $7,789.94	Facility		$595.48	$6,290.89	$7,789.94
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $1,435.09 / $9,436.34 / $10,971.11	Facility	50	$1,435.09	$9,436.34	$10,971.11
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $191.35 / $1,258.18 / $1,462.81	Facility	80	$191.35	$1,258.18	$1,462.81
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $133.94 / $880.72 / $1,023.97	Facility	AS	$133.94	$880.72	$1,023.97
Medcost Facility/Professional Professional Modifier Low / Median / High Price $6,290.89 / $6,290.89 / $6,290.89	Professional		$6,290.89	$6,290.89	$6,290.89
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $9,436.34 / $9,436.34 / $9,436.34	Professional	50	$9,436.34	$9,436.34	$9,436.34
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $715.48 / $4,201.49 / $5,156.77	Professional		$715.48	$4,201.49	$5,156.77
United Facility/Professional Professional Modifier Low / Median / High Price $3,742.88 / $6,273.06 / $12,287.43	Professional		$3,742.88	$6,273.06	$12,287.43
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $4,897.51 / $4,897.51	Facility		$55.00	$4,897.51	$4,897.51
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $223.74 / $223.74 / $223.74	Facility	AS	$223.74	$223.74	$223.74
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $14,086.04 / $23,800.94 / $24,517.50	Professional		$14,086.04	$23,800.94	$24,517.50