Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $169.82 / $263.03	Facility		$134.90	$169.82	$263.03
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $43.65 / $43.65 / $43.65	Facility	25	$43.65	$43.65	$43.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $190.55 / $398.11	Professional		$134.90	$190.55	$398.11
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $173.78 / $245.47 / $537.03	Professional	25	$173.78	$245.47	$537.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $213.80 / $309.03	Professional		$158.49	$213.80	$309.03
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $173.78 / $218.78 / $316.23	Professional	25	$173.78	$218.78	$316.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $169.82 / $169.82	Facility		$158.49	$169.82	$169.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $229.09 / $275.42	Professional		$194.98	$229.09	$275.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $158.49 / $199.53	Facility		$95.50	$158.49	$199.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $218.78 / $354.81	Professional		$162.18	$218.78	$354.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.54 / $204.17 / $331.13	Facility		$144.54	$204.17	$331.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $263.03 / $1,380.38	Professional		$190.55	$263.03	$1,380.38
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $251.19 / $288.40 / $316.23	Professional	25	$251.19	$288.40	$316.23
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $162.18 / $169.82	Facility		$162.18	$162.18	$169.82
United Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $208.93 / $288.40	Professional		$158.49	$208.93	$288.40