Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.92 / $130.79 / $140.19	Facility		$109.92	$130.79	$140.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.97 / $73.48 / $171.18	Professional		$52.97	$73.48	$171.18
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $57.00 / $87.06 / $260.80	Professional	25	$57.00	$87.06	$260.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $71.34 / $87.49 / $116.94	Professional		$71.34	$87.49	$116.94
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $90.78 / $105.03 / $122.73	Professional	25	$90.78	$105.03	$122.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $83.69 / $144.80	Professional		$55.00	$83.69	$144.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.52 / $100.06 / $149.09	Professional		$73.52	$100.06	$149.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.07 / $87.39 / $141.16	Facility		$58.07	$87.39	$141.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.61 / $111.54 / $525.69	Professional		$75.61	$111.54	$525.69
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $92.53 / $92.53 / $101.28	Professional	25	$92.53	$92.53	$101.28
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $63.25 / $63.25 / $111.21	Professional		$63.25	$63.25	$111.21
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $91.10 / $91.10 / $91.10	Professional	25	$91.10	$91.10	$91.10
United Facility/Professional Professional Modifier Low / Median / High Price $71.45 / $95.68 / $136.88	Professional		$71.45	$95.68	$136.88
United Facility/Professional Professional Modifier 25 Low / Median / High Price $98.97 / $98.97 / $99.10	Professional	25	$98.97	$98.97	$99.10