Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.38 / $187.63 / $1,222.75	Facility		$58.38	$187.63	$1,222.75
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $315.75 / $389.01 / $1,025.46	Facility	25	$315.75	$389.01	$1,025.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.76 / $114.10 / $270.00	Professional		$64.76	$114.10	$270.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $58.91 / $135.75 / $366.00	Professional	25	$58.91	$135.75	$366.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $287.60	Professional	50	$94.50	$94.50	$287.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.81 / $116.87 / $166.08	Professional		$87.81	$116.87	$166.08
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $94.11 / $110.72 / $153.78	Professional	25	$94.11	$110.72	$153.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.84 / $42.68 / $65.97	Facility		$22.84	$42.68	$65.97
BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.00 / $95.35 / $106.00	Professional		$73.00	$95.35	$106.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $120.00 / $179.00	Facility		$95.00	$120.00	$179.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.70 / $110.01 / $207.39	Professional		$73.70	$110.01	$207.39
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.94 / $108.25 / $194.00	Facility		$73.94	$108.25	$194.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $89.68 / $127.29 / $801.06	Professional		$89.68	$127.29	$801.06
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $91.80 / $115.20 / $230.10	Professional	25	$91.80	$115.20	$230.10
United Facility/Professional Professional Modifier Low / Median / High Price $81.92 / $108.72 / $202.50	Professional		$81.92	$108.72	$202.50