Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.60 / $79.34 / $115.71	Facility		$37.60	$79.34	$115.71
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $17.82 / $189.75 / $457.78	Facility	25	$17.82	$189.75	$457.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $58.28 / $110.21	Professional		$33.95	$58.28	$110.21
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $37.60 / $79.34 / $116.00	Professional	25	$37.60	$79.34	$116.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $45.45 / $64.00 / $74.98	Professional		$45.45	$64.00	$74.98
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $49.05 / $67.17 / $79.54	Professional	25	$49.05	$67.17	$79.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $68.79 / $89.14	Professional		$48.75	$68.79	$89.14
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.54 / $56.54 / $56.54	Facility		$56.54	$56.54	$56.54
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $5.48 / $5.48 / $5.48	Facility	AS	$5.48	$5.48	$5.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.35 / $52.32 / $85.48	Professional		$36.35	$52.32	$85.48
Medcost Facility/Professional Facility Modifier Low / Median / High Price $39.33 / $54.56 / $129.68	Facility		$39.33	$54.56	$129.68
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $57.00 / $62.54 / $89.57	Facility	50	$57.00	$62.54	$89.57
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $7.60 / $8.34 / $11.96	Facility	80	$7.60	$8.34	$11.96
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $5.32 / $5.84 / $8.36	Facility	AS	$5.32	$5.84	$8.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $45.00 / $93.38	Professional		$41.69	$45.00	$93.38
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $44.90 / $72.02 / $89.91	Professional		$44.90	$72.02	$89.91
United Facility/Professional Professional Modifier Low / Median / High Price $34.06 / $46.95 / $76.83	Professional		$34.06	$46.95	$76.83
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $107.04 / $107.04 / $238.31	Facility		$107.04	$107.04	$238.31
Wellcare Facility/Professional Facility Modifier AS Low / Median / High Price $10.70 / $10.70 / $23.83	Facility	AS	$10.70	$10.70	$23.83
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $368.28 / $368.28 / $368.28	Professional		$368.28	$368.28	$368.28