Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $201.54 / $993.00 / $2,560.50	Facility		$201.54	$993.00	$2,560.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $625.83 / $1,219.15 / $2,340.96	Facility	25	$625.83	$1,219.15	$2,340.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.62 / $120.09 / $265.95	Professional		$93.62	$120.09	$265.95
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $97.66 / $243.75 / $575.00	Professional	25	$97.66	$243.75	$575.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $147.07 / $203.56 / $415.53	Professional		$147.07	$203.56	$415.53
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $127.39 / $189.68 / $308.95	Professional	25	$127.39	$189.68	$308.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $142.55 / $197.94 / $261.66	Professional		$142.55	$197.94	$261.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.63 / $139.63 / $139.63	Facility		$139.63	$139.63	$139.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.21 / $162.63 / $289.51	Professional		$109.21	$162.63	$289.51
Medcost Facility/Professional Facility Modifier Low / Median / High Price $125.00 / $141.94 / $254.41	Facility		$125.00	$141.94	$254.41
Medcost Facility/Professional Professional Modifier Low / Median / High Price $111.94 / $115.00 / $285.52	Professional		$111.94	$115.00	$285.52
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $118.40 / $189.60 / $239.35	Professional		$118.40	$189.60	$239.35
United Facility/Professional Professional Modifier Low / Median / High Price $100.02 / $127.48 / $230.88	Professional		$100.02	$127.48	$230.88
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $401.30 / $573.99 / $573.99	Facility		$401.30	$573.99	$573.99
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $748.12 / $748.12 / $748.12	Professional		$748.12	$748.12	$748.12