Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.26 / $103.33 / $479.88	Facility		$58.26	$103.33	$479.88
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $98.80 / $162.62 / $489.35	Facility	25	$98.80	$162.62	$489.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.08 / $83.40 / $159.10	Professional		$50.08	$83.40	$159.10
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $54.28 / $85.00 / $164.00	Professional	25	$54.28	$85.00	$164.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.77 / $119.88 / $202.43	Professional		$74.77	$119.88	$202.43
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $83.08 / $146.05 / $202.43	Professional	25	$83.08	$146.05	$202.43
BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.34 / $119.56 / $174.59	Professional		$65.34	$119.56	$174.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.00 / $118.05 / $148.00	Facility		$67.00	$118.05	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.84 / $143.97 / $213.76	Professional		$74.84	$143.97	$213.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.26 / $99.04 / $153.37	Facility		$58.26	$99.04	$153.37
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $193.29 / $200.00 / $227.40	Facility	25	$193.29	$200.00	$227.40
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $149.93 / $186.38 / $186.38	Facility	62	$149.93	$186.38	$186.38
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $23.99 / $29.82 / $29.82	Facility	AS	$23.99	$29.82	$29.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.34 / $163.66 / $226.02	Professional		$90.34	$163.66	$226.02
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $116.90 / $160.74 / $204.72	Professional	25	$116.90	$160.74	$204.72
Midlands Facility/Professional Facility Modifier Low / Median / High Price $95.58 / $139.69 / $202.19	Facility		$95.58	$139.69	$202.19
Midlands Facility/Professional Professional Modifier Low / Median / High Price $86.18 / $133.43 / $193.46	Professional		$86.18	$133.43	$193.46
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $138.60 / $138.60 / $138.60	Facility		$138.60	$138.60	$138.60
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $64.75 / $115.58 / $182.72	Professional		$64.75	$115.58	$182.72
United Facility/Professional Professional Modifier Low / Median / High Price $84.70 / $127.04 / $186.05	Professional		$84.70	$127.04	$186.05