Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $291.30 / $786.14 / $5,449.00	Facility		$291.30	$786.14	$5,449.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $516.08 / $1,109.88 / $1,521.22	Facility	50	$516.08	$1,109.88	$1,521.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $291.30 / $500.00 / $1,243.38	Professional		$291.30	$500.00	$1,243.38
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $309.18 / $340.10 / $852.26	Professional		$309.18	$340.10	$852.26
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $637.53 / $637.53 / $637.53	Professional	50	$637.53	$637.53	$637.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $510.15 / $1,158.96 / $2,242.67	Professional		$510.15	$1,158.96	$2,242.67
Cigna Facility/Professional Professional Modifier Low / Median / High Price $337.88 / $745.22 / $1,281.77	Professional		$337.88	$745.22	$1,281.77
Medcost Facility/Professional Facility Modifier Low / Median / High Price $291.30 / $479.17 / $1,470.91	Facility		$291.30	$479.17	$1,470.91
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $475.44 / $1,686.00 / $2,117.10	Facility	50	$475.44	$1,686.00	$2,117.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $421.00 / $421.00 / $1,411.40	Professional		$421.00	$421.00	$1,411.40
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $2,117.10 / $2,117.10 / $2,117.10	Professional	50	$2,117.10	$2,117.10	$2,117.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,462.81 / $1,462.81 / $1,462.81	Facility		$1,462.81	$1,462.81	$1,462.81
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $332.56 / $407.38 / $530.35	Professional		$332.56	$407.38	$530.35
United Facility/Professional Facility Modifier Low / Median / High Price $905.00 / $2,417.00 / $4,102.00	Facility		$905.00	$2,417.00	$4,102.00
United Facility/Professional Professional Modifier Low / Median / High Price $316.93 / $905.60 / $1,920.60	Professional		$316.93	$905.60	$1,920.60
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $2,405.90	Facility		$55.00	$55.00	$2,405.90
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $4,000.04 / $4,892.37 / $5,324.36	Professional		$4,000.04	$4,892.37	$5,324.36