Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,919.00 / $8,697.15 / $14,528.00	Facility		$1,919.00	$8,697.15	$14,528.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,141.80 / $1,378.00 / $2,001.07	Professional		$1,141.80	$1,378.00	$2,001.07
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,082.96 / $1,191.68 / $1,620.32	Professional		$1,082.96	$1,191.68	$1,620.32
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,473.54 / $1,848.51 / $3,743.56	Professional		$1,473.54	$1,848.51	$3,743.56
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,255.33 / $1,701.28 / $3,627.61	Professional		$1,255.33	$1,701.28	$3,627.61
Medcost Facility/Professional Facility Modifier Low / Median / High Price $1,141.80 / $1,913.00 / $3,400.00	Facility		$1,141.80	$1,913.00	$3,400.00
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $268.00 / $382.80 / $866.40	Facility	80	$268.00	$382.80	$866.40
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $187.60 / $267.95 / $606.48	Facility	AS	$187.60	$267.95	$606.48
Medcost Facility/Professional Professional Modifier Low / Median / High Price $1,486.00 / $1,486.00 / $1,913.00	Professional		$1,486.00	$1,486.00	$1,913.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $10,993.56 / $10,993.56 / $10,993.56	Facility		$10,993.56	$10,993.56	$10,993.56
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $1,139.82 / $1,408.36 / $2,074.62	Professional		$1,139.82	$1,408.36	$2,074.62
United Facility/Professional Facility Modifier Low / Median / High Price $5,293.00 / $12,216.00 / $19,066.00	Facility		$5,293.00	$12,216.00	$19,066.00
United Facility/Professional Professional Modifier Low / Median / High Price $1,114.95 / $1,511.51 / $3,211.13	Professional		$1,114.95	$1,511.51	$3,211.13
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $7,513.80 / $11,879.05 / $26,542.00	Facility		$7,513.80	$11,879.05	$26,542.00
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $272.45 / $306.11 / $1,125.97	Facility	AS	$272.45	$306.11	$1,125.97
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $10,464.70 / $10,464.70 / $10,464.70	Professional		$10,464.70	$10,464.70	$10,464.70