Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $157.99 / $964.59 / $1,937.88	Facility		$157.99	$964.59	$1,937.88
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $663.57 / $1,252.68 / $2,339.77	Facility	25	$663.57	$1,252.68	$2,339.77
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $171.64 / $266.87 / $901.88	Professional	25	$171.64	$266.87	$901.88
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $163.46 / $168.98 / $369.30	Professional	25	$163.46	$168.98	$369.30
BCBS Facility/Professional Facility Modifier Low / Median / High Price $259.95 / $298.94 / $897.16	Facility		$259.95	$298.94	$897.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $167.03 / $213.85 / $360.34	Facility		$167.03	$213.85	$360.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $202.43 / $202.43 / $202.43	Facility		$202.43	$202.43	$202.43
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $156.40 / $964.59 / $1,937.88	Facility		$156.40	$964.59	$1,937.88
Health Alliance Plan Facility/Professional Facility Modifier 25 Low / Median / High Price $674.10 / $1,302.33 / $2,339.77	Facility	25	$674.10	$1,302.33	$2,339.77
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $171.64 / $266.87 / $2,305.80	Professional	25	$171.64	$266.87	$2,305.80