Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $954.99 / $1,862.09	Facility		$77.62	$954.99	$1,862.09
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $8.32 / $870.96 / $1,905.46	Facility	25	$8.32	$870.96	$1,905.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $67.61 / $199.53	Professional		$52.48	$67.61	$199.53
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $57.54 / $109.65 / $380.19	Professional	25	$57.54	$109.65	$380.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $83.18 / $117.49	Professional		$64.57	$83.18	$117.49
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.61 / $102.33 / $131.83	Professional	25	$67.61	$102.33	$131.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $323.59	Facility		$275.42	$275.42	$323.59
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $107.15 / $144.54	Professional		$63.10	$107.15	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $131.83 / $165.96	Professional		$61.66	$131.83	$165.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $104.71 / $933.25	Facility		$63.10	$104.71	$933.25
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $457.09 / $794.33 / $1,230.27	Facility	25	$457.09	$794.33	$1,230.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $123.03 / $177.83	Professional		$77.62	$123.03	$177.83
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $64.57 / $128.82 / $154.88	Professional	25	$64.57	$128.82	$154.88
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $117.49 / $165.96	Professional		$102.33	$117.49	$165.96
Midlands Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $154.88 / $165.96	Professional		$141.25	$154.88	$165.96
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $1,148.15 / $1,148.15 / $1,348.96	Facility		$1,148.15	$1,148.15	$1,348.96
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $117.49 / $162.18	Professional		$109.65	$117.49	$162.18
United Facility/Professional Facility Modifier Low / Median / High Price $0.06 / $0.06 / $0.06	Facility		$0.06	$0.06	$0.06
United Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $107.15 / $162.18	Professional		$72.44	$107.15	$162.18