Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $245.47 / $794.33 / $3,090.30	Facility		$245.47	$794.33	$3,090.30
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,288.25 / $2,630.27 / $5,370.32	Facility	25	$1,288.25	$2,630.27	$5,370.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $257.04 / $741.31	Professional		$173.78	$257.04	$741.31
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $181.97 / $346.74 / $933.25	Professional	25	$181.97	$346.74	$933.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $251.19 / $446.68	Professional		$190.55	$251.19	$446.68
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $194.98 / $275.42 / $457.09	Professional	25	$194.98	$275.42	$457.09
BCBS Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $416.87 / $588.84	Professional		$275.42	$416.87	$588.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $4,570.88	Facility		$331.13	$331.13	$4,570.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $309.03 / $575.44	Professional		$218.78	$309.03	$575.44
Medcost Facility/Professional Professional Modifier Low / Median / High Price $309.03 / $309.03 / $512.86	Professional		$309.03	$309.03	$512.86
Medcost Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $295.12 / $489.78	Facility		$204.17	$295.12	$489.78
Medcost Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $190.55 / $194.98	Professional		$173.78	$190.55	$194.98
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $389.05 / $645.65	Professional		$213.80	$389.05	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $3,890.45 / $3,890.45 / $3,890.45	Facility		$3,890.45	$3,890.45	$3,890.45
United Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $269.15 / $467.74	Professional		$194.98	$269.15	$467.74
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Facility		$1,348.96	$1,348.96	$1,348.96
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Professional		$1,737.80	$1,737.80	$1,737.80