Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.70 / $109.65 / $281.84	Facility		$53.70	$109.65	$281.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $87.10 / $346.74	Professional		$45.71	$87.10	$346.74
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	25	$218.78	$218.78	$218.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $61.66 / $91.20	Professional		$42.66	$61.66	$91.20
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $50.12 / $50.12 / $50.12	Professional	25	$50.12	$50.12	$50.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $58.88 / $112.20	Professional		$33.88	$58.88	$112.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Facility		$85.11	$85.11	$85.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $48.98 / $67.61	Professional		$48.98	$48.98	$67.61
Medcost Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $61.66 / $61.66	Professional		$43.65	$61.66	$61.66
Medcost Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $57.54 / $100.00	Facility		$34.67	$57.54	$100.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $28.18 / $28.18	Professional		$28.18	$28.18	$28.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $93.33 / $123.03	Professional		$54.95	$93.33	$123.03
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $52.48 / $91.20	Professional		$28.84	$52.48	$91.20
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $346.74 / $346.74 / $346.74	Facility		$346.74	$346.74	$346.74
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $346.74 / $346.74 / $446.68	Professional		$346.74	$346.74	$446.68