Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $87.10 / $316.23	Facility		$46.77	$87.10	$316.23
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $72.44 / $97.72 / $177.83	Facility	25	$72.44	$97.72	$177.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $51.29 / $120.23	Professional		$28.18	$51.29	$120.23
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $33.11 / $60.26 / $125.89	Professional	25	$33.11	$60.26	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $53.70 / $89.13	Professional		$30.90	$53.70	$89.13
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $35.48 / $54.95 / $100.00	Professional	25	$35.48	$54.95	$100.00
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $54.95 / $54.95 / $54.95	Professional	50	$54.95	$54.95	$54.95
BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.43 / $112.20 / $177.83	Facility		$79.43	$112.20	$177.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $64.57 / $104.71	Professional		$34.67	$64.57	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $74.13 / $147.91	Facility		$47.86	$74.13	$147.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $57.54 / $128.82	Professional		$30.90	$57.54	$128.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $50.12 / $91.20	Facility		$28.84	$50.12	$91.20
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $77.62 / $77.62 / $162.18	Facility	25	$77.62	$77.62	$162.18
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $93.33 / $100.00 / $100.00	Facility	62	$93.33	$100.00	$100.00
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $15.14 / $15.85 / $15.85	Facility	AS	$15.14	$15.85	$15.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $97.72 / $223.87	Professional		$51.29	$97.72	$223.87
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $69.18 / $95.50 / $123.03	Professional	25	$69.18	$95.50	$123.03
Midlands Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $81.28 / $109.65	Professional		$47.86	$81.28	$109.65
Midlands Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $75.86 / $125.89	Professional		$43.65	$75.86	$125.89
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $162.18 / $162.18	Facility		$138.04	$162.18	$162.18
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $53.70 / $102.33	Professional		$45.71	$53.70	$102.33
United Facility/Professional Facility Modifier Low / Median / High Price $177.83 / $177.83 / $177.83	Facility		$177.83	$177.83	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $51.29 / $93.33	Professional		$29.51	$51.29	$93.33