Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $954.99 / $2,137.96	Facility		$162.18	$954.99	$2,137.96
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $549.54 / $977.24 / $3,162.28	Facility	25	$549.54	$977.24	$3,162.28
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $158.49 / $316.23 / $691.83	Professional	25	$158.49	$316.23	$691.83
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $147.91 / $199.53 / $380.19	Professional	25	$147.91	$199.53	$380.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $218.78 / $380.19	Facility		$138.04	$218.78	$380.19
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $199.53 / $524.81 / $1,698.24	Facility	25	$199.53	$524.81	$1,698.24
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $199.53 / $251.19 / $323.59	Professional	25	$199.53	$251.19	$323.59
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $181.97 / $181.97 / $213.80	Professional	25	$181.97	$181.97	$213.80
United Facility/Professional Facility Modifier Low / Median / High Price $3,162.28 / $3,162.28 / $3,801.89	Facility		$3,162.28	$3,162.28	$3,801.89