Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.02 / $67.61 / $151.36	Facility		$38.02	$67.61	$151.36
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $85.11 / $162.18 / $316.23	Facility	25	$85.11	$162.18	$316.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $53.70 / $112.20	Professional		$29.51	$53.70	$112.20
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $32.36 / $56.23 / $120.23	Professional	25	$32.36	$56.23	$120.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $53.70 / $79.43	Professional		$30.90	$53.70	$79.43
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $39.81 / $54.95 / $83.18	Professional	25	$39.81	$54.95	$83.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	50	$54.95	$54.95	$54.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $52.48 / $93.33	Professional		$33.88	$52.48	$93.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $125.89 / $151.36	Facility		$54.95	$125.89	$151.36
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	22	$64.57	$64.57	$64.57
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	62	$33.88	$33.88	$33.88
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $5.37 / $5.37 / $5.37	Facility	AS	$5.37	$5.37	$5.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $48.98 / $87.10	Professional		$28.84	$48.98	$87.10
Medcost Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $45.71 / $104.71	Professional		$45.71	$45.71	$104.71
Medcost Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $47.86 / $79.43	Facility		$28.84	$47.86	$79.43
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $63.10 / $120.23	Professional		$33.88	$63.10	$120.23
United Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $48.98 / $48.98	Facility		$48.98	$48.98	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $23.44 / $38.90 / $66.07	Professional		$23.44	$38.90	$66.07
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Wellcare Facility/Professional Facility Modifier 62 Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	62	$141.25	$141.25	$141.25
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $22.39 / $22.39 / $22.39	Facility	AS	$22.39	$22.39	$22.39
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $354.81 / $354.81 / $354.81	Professional		$354.81	$354.81	$354.81