Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.50 / $112.07 / $297.89	Facility		$66.50	$112.07	$297.89
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $122.56 / $408.27 / $619.15	Facility	25	$122.56	$408.27	$619.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.03 / $109.51 / $232.42	Professional		$62.03	$109.51	$232.42
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $55.51 / $122.12 / $244.23	Professional	25	$55.51	$122.12	$244.23
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.97 / $182.57 / $285.01	Professional		$116.97	$182.57	$285.01
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $116.97 / $187.15 / $242.13	Professional	25	$116.97	$187.15	$242.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $172.34 / $246.78	Professional		$96.53	$172.34	$246.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $105.00 / $148.00 / $166.95	Facility		$105.00	$148.00	$166.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.66 / $209.71 / $302.11	Professional		$111.66	$209.71	$302.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $86.21 / $146.56 / $226.35	Facility		$86.21	$146.56	$226.35
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $194.00 / $194.00 / $278.10	Facility	25	$194.00	$194.00	$278.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $131.58 / $239.36 / $316.41	Professional		$131.58	$239.36	$316.41
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $184.12 / $233.87 / $304.12	Professional	25	$184.12	$233.87	$304.12
Midlands Facility/Professional Facility Modifier Low / Median / High Price $140.69 / $205.14 / $296.91	Facility		$140.69	$205.14	$296.91
Midlands Facility/Professional Professional Modifier Low / Median / High Price $127.13 / $187.77 / $284.10	Professional		$127.13	$187.77	$284.10
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $144.80 / $144.80 / $144.80	Facility		$144.80	$144.80	$144.80
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $95.41 / $167.20 / $260.22	Professional		$95.41	$167.20	$260.22
United Facility/Professional Professional Modifier Low / Median / High Price $111.90 / $179.62 / $252.17	Professional		$111.90	$179.62	$252.17