Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.99 / $114.56 / $144.54	Facility		$81.99	$114.56	$144.54
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $68.09 / $142.35 / $1,196.13	Facility	25	$68.09	$142.35	$1,196.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.45 / $76.38 / $163.44	Professional		$48.45	$76.38	$163.44
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $51.28 / $87.92 / $213.71	Professional	25	$51.28	$87.92	$213.71
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $254.64 / $263.30 / $271.76	Professional	50	$254.64	$263.30	$271.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.33 / $84.64 / $123.44	Professional		$60.33	$84.64	$123.44
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $70.50 / $90.50 / $130.22	Professional	25	$70.50	$90.50	$130.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $51.67 / $76.95 / $124.24	Professional		$51.67	$76.95	$124.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.08 / $120.00 / $256.00	Facility		$88.08	$120.00	$256.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $55.05 / $55.05 / $55.05	Facility	62	$55.05	$55.05	$55.05
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.81 / $8.81 / $8.81	Facility	AS	$8.81	$8.81	$8.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $83.37 / $129.94	Professional		$55.00	$83.37	$129.94
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $298.20 / $323.29 / $323.29	Facility		$298.20	$323.29	$323.29
Lucent Health Facility/Professional Facility Modifier 62 Low / Median / High Price $186.38 / $202.06 / $202.06	Facility	62	$186.38	$202.06	$202.06
Lucent Health Facility/Professional Facility Modifier AS Low / Median / High Price $29.82 / $32.33 / $32.33	Facility	AS	$29.82	$32.33	$32.33
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $413.45 / $567.54 / $567.54	Professional		$413.45	$567.54	$567.54
Optum Facility/Professional Professional Modifier Low / Median / High Price $71.00 / $86.28 / $119.36	Professional		$71.00	$86.28	$119.36
United Facility/Professional Professional Modifier Low / Median / High Price $58.64 / $77.78 / $135.90	Professional		$58.64	$77.78	$135.90