Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $81.28 / $169.82	Facility		$33.11	$81.28	$169.82
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $87.10 / $91.20 / $91.20	Facility	25	$87.10	$91.20	$91.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $50.12 / $109.65	Professional		$28.18	$50.12	$109.65
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $33.11 / $57.54 / $123.03	Professional	25	$33.11	$57.54	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $52.48 / $75.86	Professional		$30.20	$52.48	$75.86
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 $43.65 / $43.65 / $43.65	Professional	50	$43.65	$43.65	$43.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $46.77 / $81.28	Professional		$27.54	$46.77	$81.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $120.23 / $208.93	Facility		$54.95	$120.23	$208.93
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	22	$64.57	$64.57	$64.57
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	62	$33.88	$33.88	$33.88
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $5.37 / $5.37 / $5.37	Facility	AS	$5.37	$5.37	$5.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $44.67 / $79.43	Professional		$28.18	$44.67	$79.43
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $141.25 / $141.25 / $141.25	Facility	62	$141.25	$141.25	$141.25
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $22.39 / $22.39 / $22.39	Facility	AS	$22.39	$22.39	$22.39
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $354.81 / $354.81	Professional		$56.23	$354.81	$354.81
Optum Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.95 / $91.20	Professional		$39.81	$54.95	$91.20
United Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $39.81 / $66.07	Professional		$23.99	$39.81	$66.07