Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.81 / $781.00 / $1,076.00	Facility		$79.81	$781.00	$1,076.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $463.50 / $871.57 / $1,194.00	Facility	25	$463.50	$871.57	$1,194.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.97 / $62.70 / $115.84	Professional		$43.97	$62.70	$115.84
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.52 / $96.97 / $241.59	Professional	25	$66.52	$96.97	$241.59
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.52 / $88.80 / $152.28	Professional		$66.52	$88.80	$152.28
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $66.52 / $85.88 / $118.34	Professional	25	$66.52	$85.88	$118.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.31 / $74.55 / $126.04	Professional		$59.31	$74.55	$126.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.40 / $90.41 / $158.38	Professional		$64.40	$90.41	$158.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.11 / $89.18 / $158.15	Facility		$57.11	$89.18	$158.15
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $315.75 / $479.50 / $775.67	Facility	25	$315.75	$479.50	$775.67
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.06 / $88.29 / $500.00	Professional		$57.06	$88.29	$500.00
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $68.80 / $99.82 / $119.48	Professional	25	$68.80	$99.82	$119.48
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $89.67 / $91.79 / $116.36	Professional		$89.67	$91.79	$116.36
United Facility/Professional Professional Modifier Low / Median / High Price $51.89 / $70.37 / $111.57	Professional		$51.89	$70.37	$111.57