Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $171.97 / $229.30 / $325.08	Facility		$171.97	$229.30	$325.08
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $312.50 / $312.50 / $312.50	Facility	25	$312.50	$312.50	$312.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.59 / $202.56 / $494.73	Professional		$117.59	$202.56	$494.73
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $158.72 / $271.06 / $636.00	Professional	25	$158.72	$271.06	$636.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $190.67 / $243.07 / $315.88	Professional		$190.67	$243.07	$315.88
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $189.81 / $241.16 / $315.88	Professional	25	$189.81	$241.16	$315.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $150.13 / $193.69 / $302.80	Professional		$150.13	$193.69	$302.80
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 $174.18 / $242.17 / $364.80	Professional		$174.18	$242.17	$364.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.55 / $222.82 / $353.62	Facility		$139.55	$222.82	$353.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $179.45 / $271.48 / $1,377.15	Professional		$179.45	$271.48	$1,377.15
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $223.16 / $271.48 / $369.82	Professional	25	$223.16	$271.48	$369.82
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $244.42 / $279.52 / $381.24	Professional		$244.42	$279.52	$381.24
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $244.42 / $244.42 / $264.77	Professional	25	$244.42	$244.42	$264.77
United Facility/Professional Professional Modifier Low / Median / High Price $170.28 / $220.94 / $327.01	Professional		$170.28	$220.94	$327.01
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $88.00 / $90.00	Professional	25	$80.00	$88.00	$90.00