Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.12 / $748.12 / $1,281.05	Facility		$61.12	$748.12	$1,281.05
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $483.16 / $789.05 / $1,882.54	Facility	25	$483.16	$789.05	$1,882.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.88 / $64.29 / $146.40	Professional		$50.88	$64.29	$146.40
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $56.25 / $115.00 / $218.42	Professional	25	$56.25	$115.00	$218.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $121.05 / $155.24	Professional		$76.45	$121.05	$155.24
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $76.45 / $111.49 / $155.24	Professional	25	$76.45	$111.49	$155.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $108.79 / $145.05	Professional		$63.82	$108.79	$145.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $71.26 / $137.96 / $164.58	Professional		$71.26	$137.96	$164.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $62.69 / $106.57 / $721.60	Facility		$62.69	$106.57	$721.60
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $454.35 / $790.00 / $1,220.00	Facility	25	$454.35	$790.00	$1,220.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $76.95 / $122.15 / $180.00	Professional		$76.95	$122.15	$180.00
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $64.29 / $122.71 / $155.58	Professional	25	$64.29	$122.71	$155.58
Midlands Facility/Professional Facility Modifier Low / Median / High Price $102.38 / $132.44 / $164.58	Facility		$102.38	$132.44	$164.58
Midlands Facility/Professional Professional Modifier Low / Median / High Price $92.61 / $118.36 / $163.90	Professional		$92.61	$118.36	$163.90
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $72.42 / $127.41 / $143.35	Professional		$72.42	$127.41	$143.35
United Facility/Professional Professional Modifier Low / Median / High Price $75.70 / $118.04 / $169.47	Professional		$75.70	$118.04	$169.47