Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $128.82 / $331.13	Facility		$77.62	$128.82	$331.13
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $91.20 / $316.23 / $616.60	Facility	25	$91.20	$316.23	$616.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $120.23 / $295.12	Professional		$54.95	$120.23	$295.12
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $60.26 / $125.89 / $316.23	Professional	25	$60.26	$125.89	$316.23
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $95.50 / $95.50 / $234.42	Professional	50	$95.50	$95.50	$234.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $117.49 / $165.96	Professional		$81.28	$117.49	$165.96
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $95.50 / $123.03 / $165.96	Professional	25	$95.50	$123.03	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $147.91	Professional		$75.86	$104.71	$147.91
Anthem BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $75.86 / $75.86 / $75.86	Professional	25	$75.86	$75.86	$75.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $125.89 / $162.18	Professional		$85.11	$125.89	$162.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $147.91 / $229.09	Facility		$120.23	$147.91	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $117.49 / $194.98	Professional		$81.28	$117.49	$194.98
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.18 / $112.20 / $204.17	Facility		$69.18	$112.20	$204.17
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $25.12 / $25.12 / $537.03	Facility	25	$25.12	$25.12	$537.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $147.91 / $794.33	Professional		$97.72	$147.91	$794.33
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $109.65 / $138.04 / $190.55	Professional	25	$109.65	$138.04	$190.55
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $141.25 / $208.93	Professional		$91.20	$141.25	$208.93
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $91.20 / $141.25 / $208.93	Professional	25	$91.20	$141.25	$208.93
United Facility/Professional Facility Modifier Low / Median / High Price $42.66 / $42.66 / $69.18	Facility		$42.66	$42.66	$69.18
United Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $100.00 / $154.88	Professional		$69.18	$100.00	$154.88