Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.80 / $146.16 / $321.48	Facility		$98.80	$146.16	$321.48
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $123.50 / $123.50 / $135.10	Facility	25	$123.50	$123.50	$135.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.60 / $172.62 / $368.00	Professional		$101.60	$172.62	$368.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $133.96 / $300.00 / $370.91	Professional	25	$133.96	$300.00	$370.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.01 / $250.82 / $370.39	Professional		$152.01	$250.82	$370.39
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $152.01 / $267.45 / $370.39	Professional	25	$152.01	$267.45	$370.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $131.47 / $229.62 / $319.89	Professional		$131.47	$229.62	$319.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $148.00 / $148.00 / $217.61	Facility		$148.00	$148.00	$217.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.00 / $301.43 / $391.63	Professional		$169.00	$301.43	$391.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $117.07 / $202.13 / $346.19	Facility		$117.07	$202.13	$346.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $192.01 / $310.67 / $835.50	Professional		$192.01	$310.67	$835.50
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $265.58 / $321.00 / $399.82	Professional	25	$265.58	$321.00	$399.82
Midlands Facility/Professional Facility Modifier Low / Median / High Price $193.59 / $285.57 / $376.26	Facility		$193.59	$285.57	$376.26
Midlands Facility/Professional Professional Modifier Low / Median / High Price $193.59 / $257.43 / $376.26	Professional		$193.59	$257.43	$376.26
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $237.20 / $237.20 / $237.20	Facility		$237.20	$237.20	$237.20
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $128.96 / $228.48 / $342.02	Professional		$128.96	$228.48	$342.02
United Facility/Professional Facility Modifier Low / Median / High Price $152.00 / $176.00 / $188.95	Facility		$152.00	$176.00	$188.95
United Facility/Professional Professional Modifier Low / Median / High Price $185.82 / $278.73 / $399.58	Professional		$185.82	$278.73	$399.58