Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $70.79 / $181.97	Facility		$30.20	$70.79	$181.97
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $89.13 / $162.18 / $338.84	Facility	25	$89.13	$162.18	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $53.70 / $123.03	Professional		$28.84	$53.70	$123.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $33.11 / $60.26 / $134.90	Professional	25	$33.11	$60.26	$134.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $51.29 / $72.44	Professional		$29.51	$51.29	$72.44
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $39.81 / $53.70 / $72.44	Professional	25	$39.81	$53.70	$72.44
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	50	$54.95	$54.95	$54.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $40.74 / $60.26	Professional		$26.92	$40.74	$60.26
Anthem BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $34.67 / $34.67 / $34.67	Professional	25	$34.67	$34.67	$34.67
BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $51.29 / $70.79	Professional		$30.90	$51.29	$70.79
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 $28.84 / $45.71 / $81.28	Professional		$28.84	$45.71	$81.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.70 / $44.67 / $87.10	Facility		$25.70	$44.67	$87.10
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $57.54 / $177.83 / $257.04	Facility	25	$57.54	$177.83	$257.04
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $100.00 / $100.00 / $100.00	Facility	62	$100.00	$100.00	$100.00
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $15.85 / $15.85 / $15.85	Facility	AS	$15.85	$15.85	$15.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $57.54 / $354.81	Professional		$38.02	$57.54	$354.81
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $42.66 / $64.57 / $128.82	Professional	25	$42.66	$64.57	$128.82
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $61.66 / $74.13	Professional		$42.66	$61.66	$74.13
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $56.23 / $67.61 / $72.44	Professional	25	$56.23	$67.61	$72.44
United Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $33.11 / $48.98	Facility		$33.11	$33.11	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $39.81 / $64.57	Professional		$23.99	$39.81	$64.57