Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $192.61 / $925.69 / $1,913.93	Facility		$192.61	$925.69	$1,913.93
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $598.80 / $974.12 / $2,745.67	Facility	25	$598.80	$974.12	$2,745.67
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $160.62 / $240.70 / $780.00	Professional	25	$160.62	$240.70	$780.00
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $164.88 / $212.90 / $376.97	Professional	25	$164.88	$212.90	$376.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.80 / $223.28 / $383.46	Facility		$139.80	$223.28	$383.46
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $200.00 / $530.35 / $1,693.74	Facility	25	$200.00	$530.35	$1,693.74
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $201.75 / $255.41 / $565.80	Professional	25	$201.75	$255.41	$565.80
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $212.44 / $212.44 / $212.44	Professional	25	$212.44	$212.44	$212.44