Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $158.49 / $213.80 / $575.44	Facility		$158.49	$213.80	$575.44
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $676.08 / $794.33 / $2,089.30	Facility	25	$676.08	$794.33	$2,089.30
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $83.18 / $177.83 / $630.96	Professional	25	$83.18	$177.83	$630.96
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $131.83 / $169.82 / $302.00	Professional	25	$131.83	$169.82	$302.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $1,819.70 / $2,884.03	Facility		$1,548.82	$1,819.70	$2,884.03
Providence Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $239.88 / $380.19	Facility		$162.18	$239.88	$380.19
United Facility/Professional Facility Modifier Low / Median / High Price $2,570.40 / $2,570.40 / $2,570.40	Facility		$2,570.40	$2,570.40	$2,570.40