Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.15 / $685.68 / $5,449.00	Facility		$109.15	$685.68	$5,449.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $350.51 / $715.91 / $954.40	Facility	50	$350.51	$715.91	$954.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.65 / $109.15 / $220.68	Professional		$87.65	$109.15	$220.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $126.75 / $171.83 / $467.20	Professional	50	$126.75	$171.83	$467.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $103.37 / $113.71 / $173.74	Professional		$103.37	$113.71	$173.74
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $154.80 / $170.57 / $230.94	Professional	50	$154.80	$170.57	$230.94
BCBS Facility/Professional Professional Modifier Low / Median / High Price $161.88 / $265.07 / $340.53	Professional		$161.88	$265.07	$340.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.01 / $179.18 / $316.70	Professional		$98.01	$179.18	$316.70
Medcost Facility/Professional Facility Modifier Low / Median / High Price $88.28 / $150.69 / $630.00	Facility		$88.28	$150.69	$630.00
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $158.93 / $484.50 / $945.00	Facility	50	$158.93	$484.50	$945.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $126.00 / $126.00 / $249.51	Professional		$126.00	$126.00	$249.51
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $374.27 / $374.27 / $374.27	Professional	50	$374.27	$374.27	$374.27
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $827.38 / $901.80 / $2,597.79	Facility		$827.38	$901.80	$2,597.79
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $101.40 / $130.36 / $161.82	Professional		$101.40	$130.36	$161.82
United Facility/Professional Facility Modifier Low / Median / High Price $252.57 / $874.00 / $2,229.00	Facility		$252.57	$874.00	$2,229.00
United Facility/Professional Professional Modifier Low / Median / High Price $97.62 / $178.94 / $293.33	Professional		$97.62	$178.94	$293.33
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $1,169.94	Facility		$55.00	$55.00	$1,169.94
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,169.94 / $1,700.65 / $3,253.02	Professional		$1,169.94	$1,700.65	$3,253.02