Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.75 / $118.45 / $1,615.00	Facility		$74.75	$118.45	$1,615.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $74.75 / $97.46 / $157.50	Professional		$74.75	$97.46	$157.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $168.47 / $280.64 / $280.64	Professional	50	$168.47	$280.64	$280.64
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $130.04 / $130.04 / $130.04	Professional	50	$130.04	$130.04	$130.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.02 / $133.60 / $274.55	Professional		$91.02	$133.60	$274.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.41 / $123.81 / $255.69	Professional		$85.41	$123.81	$255.69
Medcost Facility/Professional Facility Modifier Low / Median / High Price $74.75 / $92.74 / $190.99	Facility		$74.75	$92.74	$190.99
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $102.00 / $133.50 / $330.03	Facility	50	$102.00	$133.50	$330.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $109.00 / $109.00 / $142.66	Professional		$109.00	$109.00	$142.66
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $214.01 / $214.01 / $214.01	Professional	50	$214.01	$214.01	$214.01
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 $79.76 / $109.97 / $242.63	Professional		$79.76	$109.97	$242.63
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $55.00 / $55.00 / $544.44	Facility		$55.00	$55.00	$544.44
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $577.52 / $1,055.57 / $1,055.57	Professional		$577.52	$1,055.57	$1,055.57