Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $933.25 / $5,248.07	Facility		$85.11	$933.25	$5,248.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $239.88 / $537.03	Professional		$85.11	$239.88	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.90 / $74.13 / $707.95	Professional		$38.90	$74.13	$707.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $257.04 / $588.84	Professional		$134.90	$257.04	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $323.59 / $524.81 / $851.14	Facility		$323.59	$524.81	$851.14
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $117.49 / $117.49 / $117.49	Facility	52	$117.49	$117.49	$117.49
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $29.51 / $29.51 / $29.51	Facility	53	$29.51	$29.51	$29.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $245.47 / $512.86	Professional		$109.65	$245.47	$512.86
Medcost Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Medcost Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $234.42 / $436.52	Facility		$89.13	$234.42	$436.52
Medcost Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Professional		$194.98	$194.98	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $269.15 / $457.09 / $575.44	Professional		$269.15	$457.09	$575.44
United Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $1,778.28 / $5,888.44	Facility		$398.11	$1,778.28	$5,888.44
United Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $190.55 / $354.81	Professional		$87.10	$190.55	$354.81
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $2,884.03 / $19,498.45	Facility		$2,884.03	$2,884.03	$19,498.45
Wellcare Facility/Professional Facility Modifier 52 Low / Median / High Price $2,290.87 / $2,290.87 / $2,290.87	Facility	52	$2,290.87	$2,290.87	$2,290.87
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $575.44 / $575.44 / $575.44	Facility	53	$575.44	$575.44	$575.44
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,862.09 / $1,862.09 / $2,187.76	Professional		$1,862.09	$1,862.09	$2,187.76