Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.34 / $104.98 / $293.63	Facility		$66.34	$104.98	$293.63
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $97.49 / $254.18 / $305.27	Facility	25	$97.49	$254.18	$305.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.49 / $101.89 / $229.04	Professional		$59.49	$101.89	$229.04
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $71.56 / $124.98 / $260.75	Professional	25	$71.56	$124.98	$260.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $86.00 / $116.76 / $159.19	Professional		$86.00	$116.76	$159.19
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $91.16 / $116.76 / $159.19	Professional	25	$91.16	$116.76	$159.19
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.62 / $97.30 / $150.99	Professional		$73.62	$97.30	$150.99
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.00 / $148.00 / $200.00	Facility		$120.00	$148.00	$200.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.44 / $118.03 / $190.32	Professional		$81.44	$118.03	$190.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $65.86 / $105.85 / $177.68	Facility		$65.86	$105.85	$177.68
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $102.74 / $214.76 / $279.12	Facility	25	$102.74	$214.76	$279.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $92.95 / $141.01 / $699.27	Professional		$92.95	$141.01	$699.27
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $101.17 / $133.68 / $186.61	Professional	25	$101.17	$133.68	$186.61
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $111.21 / $156.29 / $192.13	Professional		$111.21	$156.29	$192.13
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $99.25 / $136.02 / $161.33	Professional	25	$99.25	$136.02	$161.33
United Facility/Professional Professional Modifier Low / Median / High Price $89.43 / $114.36 / $172.68	Professional		$89.43	$114.36	$172.68