Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.86 / $1,845.47 / $5,576.63	Facility		$86.86	$1,845.47	$5,576.63
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $732.72 / $4,799.27 / $4,799.27	Facility	50	$732.72	$4,799.27	$4,799.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.86 / $92.63 / $194.17	Professional		$51.86	$92.63	$194.17
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $130.29 / $378.45 / $378.45	Professional	50	$130.29	$378.45	$378.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.04 / $174.34 / $368.84	Professional		$85.04	$174.34	$368.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.59 / $111.59 / $395.75	Facility		$111.59	$111.59	$395.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $117.67 / $244.04	Professional		$75.00	$117.67	$244.04
Medcost Facility/Professional Facility Modifier Low / Median / High Price $53.42 / $99.00 / $176.99	Facility		$53.42	$99.00	$176.99
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $132.32 / $148.50 / $304.17	Facility	50	$132.32	$148.50	$304.17
Medcost Facility/Professional Professional Modifier Low / Median / High Price $88.21 / $147.00 / $149.00	Professional		$88.21	$147.00	$149.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $132.32 / $132.32 / $132.32	Professional	50	$132.32	$132.32	$132.32
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $30,937.16 / $31,255.87 / $34,811.72	Facility		$30,937.16	$31,255.87	$34,811.72
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $76.73 / $114.61 / $213.13	Professional		$76.73	$114.61	$213.13
United Facility/Professional Facility Modifier Low / Median / High Price $554.00 / $2,417.00 / $4,102.00	Facility		$554.00	$2,417.00	$4,102.00
United Facility/Professional Professional Modifier Low / Median / High Price $73.05 / $116.61 / $308.07	Professional		$73.05	$116.61	$308.07
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $307.18 / $307.18	Facility		$55.00	$307.18	$307.18
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $912.00 / $1,094.00 / $1,094.00	Professional		$912.00	$1,094.00	$1,094.00