Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.07 / $118.00 / $218.02	Facility		$49.07	$118.00	$218.02
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $91.38 / $165.43 / $227.56	Facility	25	$91.38	$165.43	$227.56
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.88 / $109.00 / $267.72	Professional		$67.88	$109.00	$267.72
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $72.61 / $119.34 / $272.80	Professional	25	$72.61	$119.34	$272.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.31 / $133.51 / $183.09	Professional		$86.31	$133.51	$183.09
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $93.08 / $132.94 / $183.09	Professional	25	$93.08	$132.94	$183.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.62 / $142.69 / $215.20	Professional		$98.62	$142.69	$215.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $120.00 / $150.00	Facility		$95.00	$120.00	$150.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.59 / $120.41 / $204.25	Professional		$77.59	$120.41	$204.25
Medcost Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $109.00 / $163.86	Facility		$81.70	$109.00	$163.86
Medcost Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $135.00 / $155.00	Professional		$65.00	$135.00	$155.00
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $83.56 / $134.54 / $211.15	Professional		$83.56	$134.54	$211.15
United Facility/Professional Professional Modifier Low / Median / High Price $83.12 / $110.83 / $207.46	Professional		$83.12	$110.83	$207.46
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $211.64 / $399.71 / $399.71	Facility		$211.64	$399.71	$399.71
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $514.87 / $699.27 / $699.27	Professional		$514.87	$699.27	$699.27