Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $112.68 / $227.49 / $5,449.00	Facility		$112.68	$227.49	$5,449.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $290.14 / $535.16 / $535.16	Facility	50	$290.14	$535.16	$535.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.78 / $142.55 / $278.33	Professional		$103.78	$142.55	$278.33
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $177.23 / $248.97 / $614.25	Professional	50	$177.23	$248.97	$614.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $122.09 / $122.09 / $131.28	Professional		$122.09	$122.09	$131.28
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $195.66 / $195.66 / $201.45	Professional	50	$195.66	$195.66	$201.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.42 / $161.97 / $333.37	Professional		$123.42	$161.97	$333.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.17 / $165.84 / $353.85	Professional		$114.17	$165.84	$353.85
Medcost Facility/Professional Facility Modifier Low / Median / High Price $112.68 / $156.81 / $266.00	Facility		$112.68	$156.81	$266.00
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $181.50 / $256.85 / $413.72	Facility	50	$181.50	$256.85	$413.72
Medcost Facility/Professional Professional Modifier Low / Median / High Price $171.23 / $182.00 / $182.00	Professional		$171.23	$182.00	$182.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $256.85 / $256.85 / $256.85	Professional	50	$256.85	$256.85	$256.85
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $128.78 / $166.08 / $206.44	Professional		$128.78	$166.08	$206.44
United Facility/Professional Facility Modifier Low / Median / High Price $361.00 / $896.00 / $2,229.00	Facility		$361.00	$896.00	$2,229.00
United Facility/Professional Professional Modifier Low / Median / High Price $116.72 / $157.80 / $378.87	Professional		$116.72	$157.80	$378.87
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $802.02	Facility		$55.00	$55.00	$802.02
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $853.20 / $1,141.28 / $1,187.25	Professional		$853.20	$1,141.28	$1,187.25