Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $173.11 / $497.28 / $940.04	Facility		$173.11	$497.28	$940.04
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $336.89 / $387.18 / $869.14	Facility	25	$336.89	$387.18	$869.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $90.95 / $119.14 / $685.31	Professional		$90.95	$119.14	$685.31
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $98.86 / $431.65 / $1,820.48	Professional	25	$98.86	$431.65	$1,820.48
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $118.29 / $150.74 / $210.32	Professional		$118.29	$150.74	$210.32
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $139.16 / $179.26 / $237.10	Professional	25	$139.16	$179.26	$237.10
BCBS Facility/Professional Professional Modifier Low / Median / High Price $138.81 / $202.84 / $265.89	Professional		$138.81	$202.84	$265.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $143.15 / $143.15 / $4,636.00	Facility		$143.15	$143.15	$4,636.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $107.68 / $152.84 / $249.20	Professional		$107.68	$152.84	$249.20
Medcost Facility/Professional Facility Modifier Low / Median / High Price $102.85 / $128.33 / $202.54	Facility		$102.85	$128.33	$202.54
Medcost Facility/Professional Professional Modifier Low / Median / High Price $90.00 / $154.00 / $296.04	Professional		$90.00	$154.00	$296.04
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $108.27 / $181.82 / $253.06	Professional		$108.27	$181.82	$253.06
United Facility/Professional Professional Modifier Low / Median / High Price $103.28 / $129.72 / $238.44	Professional		$103.28	$129.72	$238.44
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $90.00	Professional	25	$80.00	$80.00	$90.00
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $226.05 / $514.57 / $514.57	Facility		$226.05	$514.57	$514.57
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $671.20 / $1,183.50 / $1,183.50	Professional		$671.20	$1,183.50	$1,183.50