Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.27 / $97.25 / $267.61	Facility		$59.27	$97.25	$267.61
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $63.49 / $204.24 / $778.91	Facility	25	$63.49	$204.24	$778.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.50 / $78.65 / $147.28	Professional		$43.50	$78.65	$147.28
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $46.88 / $85.00 / $156.71	Professional	25	$46.88	$85.00	$156.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $254.64 / $262.68 / $271.76	Professional	50	$254.64	$262.68	$271.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.82 / $90.99 / $129.83	Professional		$62.82	$90.99	$129.83
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $68.73 / $93.92 / $124.07	Professional	25	$68.73	$93.92	$124.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.46 / $70.54 / $104.76	Professional		$50.46	$70.54	$104.76
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 $55.44 / $87.54 / $134.21	Professional		$55.44	$87.54	$134.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.70 / $81.26 / $139.82	Facility		$50.70	$81.26	$139.82
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $69.62 / $235.32 / $410.88	Facility	25	$69.62	$235.32	$410.88
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $186.38 / $186.38 / $186.38	Facility	62	$186.38	$186.38	$186.38
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $29.82 / $29.82 / $29.82	Facility	AS	$29.82	$29.82	$29.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.86 / $101.56 / $567.54	Professional		$62.86	$101.56	$567.54
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $78.39 / $103.99 / $150.27	Professional	25	$78.39	$103.99	$150.27
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $75.64 / $113.34 / $149.30	Professional		$75.64	$113.34	$149.30
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $79.81 / $123.66 / $149.30	Professional	25	$79.81	$123.66	$149.30
United Facility/Professional Professional Modifier Low / Median / High Price $57.11 / $79.59 / $119.55	Professional		$57.11	$79.59	$119.55