Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $105.21 / $143.84 / $306.26	Facility		$105.21	$143.84	$306.26
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $350.21 / $568.86 / $638.75	Facility	25	$350.21	$568.86	$638.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.53 / $161.25 / $349.27	Professional		$87.53	$161.25	$349.27
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $106.30 / $185.24 / $385.00	Professional	25	$106.30	$185.24	$385.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $127.23 / $176.03 / $239.01	Professional		$127.23	$176.03	$239.01
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $150.97 / $183.68 / $239.01	Professional	25	$150.97	$183.68	$239.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.80 / $149.91 / $232.82	Professional		$117.80	$149.91	$232.82
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 $131.71 / $186.06 / $285.02	Professional		$131.71	$186.06	$285.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.62 / $167.05 / $270.80	Facility		$103.62	$167.05	$270.80
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $50.00 / $50.00 / $50.00	Facility	25	$50.00	$50.00	$50.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $142.03 / $213.68 / $1,041.60	Professional		$142.03	$213.68	$1,041.60
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $160.60 / $204.41 / $280.25	Professional	25	$160.60	$204.41	$280.25
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $160.91 / $237.76 / $288.47	Professional		$160.91	$237.76	$288.47
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $160.91 / $237.76 / $274.86	Professional	25	$160.91	$237.76	$274.86
United Facility/Professional Facility Modifier Low / Median / High Price $141.00 / $141.00 / $188.95	Facility		$141.00	$141.00	$188.95
United Facility/Professional Professional Modifier Low / Median / High Price $136.82 / $175.17 / $257.60	Professional		$136.82	$175.17	$257.60