Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $147.91 / $309.03	Facility		$95.50	$147.91	$309.03
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $346.74 / $575.44 / $645.65	Facility	25	$346.74	$575.44	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $173.78 / $426.58	Professional		$100.00	$173.78	$426.58
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $114.82 / $199.53 / $457.09	Professional	25	$114.82	$199.53	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $123.03 / $162.18 / $218.78	Professional		$123.03	$162.18	$218.78
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $128.82 / $165.96 / $213.80	Professional	25	$128.82	$165.96	$213.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $144.54 / $223.87	Professional		$120.23	$144.54	$223.87
Anthem BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $125.89 / $125.89 / $125.89	Professional	25	$125.89	$125.89	$125.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $173.78 / $218.78	Professional		$117.49	$173.78	$218.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $147.91 / $229.09	Facility		$120.23	$147.91	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $169.82 / $275.42	Professional		$128.82	$169.82	$275.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $158.49 / $275.42	Facility		$100.00	$158.49	$275.42
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $50.12 / $50.12 / $50.12	Facility	25	$50.12	$50.12	$50.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $204.17 / $1,047.13	Professional		$138.04	$204.17	$1,047.13
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $154.88 / $194.98 / $269.15	Professional	25	$154.88	$194.98	$269.15
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $186.21 / $275.42	Professional		$125.89	$186.21	$275.42
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $147.91 / $186.21 / $218.78	Professional	25	$147.91	$186.21	$218.78
United Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $72.44 / $131.83	Facility		$69.18	$72.44	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $229.09	Professional		$109.65	$154.88	$229.09