Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.77 / $257.81 / $869.16	Facility		$96.77	$257.81	$869.16
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $893.76 / $1,198.58 / $1,633.24	Facility	25	$893.76	$1,198.58	$1,633.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.60 / $162.69 / $390.00	Professional		$101.60	$162.69	$390.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $122.27 / $193.69 / $530.00	Professional	25	$122.27	$193.69	$530.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.30 / $160.43 / $224.60	Professional		$112.30	$160.43	$224.60
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $122.73 / $152.41 / $203.75	Professional	25	$122.73	$152.41	$203.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $25.04 / $35.33 / $49.59	Facility		$25.04	$35.33	$49.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.62 / $124.35 / $138.18	Professional		$98.62	$124.35	$138.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $120.00 / $217.61	Facility		$95.00	$120.00	$217.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $113.36 / $161.99 / $315.18	Professional		$113.36	$161.99	$315.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.11 / $152.40 / $274.33	Facility		$108.11	$152.40	$274.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $137.55 / $186.92 / $1,041.60	Professional		$137.55	$186.92	$1,041.60
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $130.05 / $186.94 / $374.40	Professional	25	$130.05	$186.94	$374.40
United Facility/Professional Facility Modifier Low / Median / High Price $100.89 / $124.18 / $188.95	Facility		$100.89	$124.18	$188.95
United Facility/Professional Professional Modifier Low / Median / High Price $133.62 / $162.28 / $306.41	Professional		$133.62	$162.28	$306.41