Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $106.23 / $109.46 / $178.46	Facility	26	$106.23	$109.46	$178.46
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $46.92 / $46.92 / $77.41	Facility	53	$46.92	$46.92	$77.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $233.68 / $315.19 / $442.27	Professional		$233.68	$315.19	$442.27
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $97.98 / $114.44 / $315.20	Professional	26	$97.98	$114.44	$315.20
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $120.79 / $158.32 / $211.38	Professional	26	$120.79	$158.32	$211.38
BCBS Facility/Professional Professional Modifier Low / Median / High Price $279.77 / $279.77 / $279.77	Professional		$279.77	$279.77	$279.77
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $152.19 / $238.45 / $339.45	Professional	26	$152.19	$238.45	$339.45
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $120.36 / $120.36 / $120.36	Facility	26	$120.36	$120.36	$120.36
Cigna Facility/Professional Facility Modifier 53 Low / Median / High Price $52.64 / $52.64 / $52.64	Facility	53	$52.64	$52.64	$52.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $277.81 / $401.19 / $721.81	Professional		$277.81	$401.19	$721.81
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $115.45 / $168.50 / $304.43	Professional	26	$115.45	$168.50	$304.43
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $118.70 / $184.00 / $272.00	Facility	26	$118.70	$184.00	$272.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $138.00 / $309.00 / $863.36	Professional		$138.00	$309.00	$863.36
Medcost Facility/Professional Professional Modifier 26 Low / Median / High Price $118.70 / $184.00 / $390.93	Professional	26	$118.70	$184.00	$390.93
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $132.33 / $201.73 / $416.30	Professional		$132.33	$201.73	$416.30
United Facility/Professional Professional Modifier Low / Median / High Price $238.72 / $352.93 / $663.51	Professional		$238.72	$352.93	$663.51
United Facility/Professional Professional Modifier 26 Low / Median / High Price $103.36 / $142.09 / $290.47	Professional	26	$103.36	$142.09	$290.47
Wellcare Facility/Professional Facility Modifier 26 Low / Median / High Price $760.56 / $961.28 / $961.28	Facility	26	$760.56	$961.28	$961.28
Wellcare Facility/Professional Facility Modifier 53 Low / Median / High Price $97.84 / $243.44 / $243.44	Facility	53	$97.84	$243.44	$243.44
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,920.39 / $1,920.39 / $1,927.13	Professional		$1,920.39	$1,920.39	$1,927.13
Wellcare Facility/Professional Professional Modifier 26 Low / Median / High Price $834.53 / $834.53 / $1,030.27	Professional	26	$834.53	$834.53	$1,030.27