Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $163.19 / $183.47 / $242.89	Facility		$163.19	$183.47	$242.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.40 / $163.19 / $306.00	Professional		$134.40	$163.19	$306.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $115.53 / $226.46 / $355.88	Professional	25	$115.53	$226.46	$355.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $130.41 / $148.91 / $274.20	Professional		$130.41	$148.91	$274.20
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $153.44 / $153.44 / $241.58	Professional	25	$153.44	$153.44	$241.58
BCBS Facility/Professional Professional Modifier Low / Median / High Price $191.80 / $272.66 / $388.32	Professional		$191.80	$272.66	$388.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $187.13 / $187.13	Facility		$187.13	$187.13	$187.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $147.60 / $147.60	Professional		$147.60	$147.60	$147.60
Medcost Facility/Professional Facility Modifier Low / Median / High Price $155.36 / $163.19 / $261.12	Facility		$155.36	$163.19	$261.12
Medcost Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $156.69 / $405.66	Professional		$39.29	$156.69	$405.66
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $158.66 / $262.55 / $309.80	Professional		$158.66	$262.55	$309.80
United Facility/Professional Professional Modifier Low / Median / High Price $151.15 / $190.16 / $328.64	Professional		$151.15	$190.16	$328.64
Wellcare Facility/Professional Facility Modifier Low / Median / High Price $285.58 / $842.92 / $842.92	Facility		$285.58	$842.92	$842.92
Wellcare Facility/Professional Professional Modifier Low / Median / High Price $1,045.69 / $1,358.33 / $1,358.33	Professional		$1,045.69	$1,358.33	$1,358.33