Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $147.91 / $316.23	Facility		$85.11	$147.91	$316.23
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $83.18 / $100.00 / $213.80	Facility	25	$83.18	$100.00	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $109.65 / $263.03	Professional		$66.07	$109.65	$263.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $67.61 / $141.25 / $281.84	Professional	25	$67.61	$141.25	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $109.65 / $177.83	Professional		$79.43	$109.65	$177.83
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $85.11 / $112.20 / $190.55	Professional	25	$85.11	$112.20	$190.55
BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $223.87	Facility		$117.49	$117.49	$223.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $138.04 / $208.93	Professional		$81.28	$138.04	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $123.03 / $147.91 / $147.91	Facility		$123.03	$147.91	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.18 / $141.25 / $257.04	Professional		$83.18	$141.25	$257.04
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $112.20 / $181.97	Facility		$72.44	$112.20	$181.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $194.98 / $512.86	Professional		$109.65	$194.98	$512.86
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $138.04 / $194.98 / $263.03	Professional	25	$138.04	$194.98	$263.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $162.18 / $213.80	Professional		$144.54	$162.18	$213.80
Midlands Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $181.97 / $251.19	Professional		$128.82	$181.97	$251.19
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $331.13	Facility		$275.42	$275.42	$331.13
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $125.89 / $218.78	Professional		$81.28	$125.89	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $123.03 / $208.93	Professional		$81.28	$123.03	$208.93