Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.95 / $66.95 / $73.36	Facility		$66.95	$66.95	$73.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $39.88 / $73.36 / $161.12	Professional		$39.88	$73.36	$161.12
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $60.99 / $127.58 / $172.92	Professional	25	$60.99	$127.58	$172.92
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $127.52 / $182.77	Professional		$65.00	$127.52	$182.77
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $63.76 / $120.51 / $166.88	Professional	25	$63.76	$120.51	$166.88
BCBS Facility/Professional Facility Modifier Low / Median / High Price $269.72 / $301.64 / $301.64	Facility		$269.72	$301.64	$301.64
BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $121.52 / $165.00	Professional		$71.65	$121.52	$165.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.69 / $158.12 / $216.05	Professional		$108.69	$158.12	$216.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $66.95 / $111.66 / $181.46	Facility		$66.95	$111.66	$181.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $99.95 / $162.88 / $525.69	Professional		$99.95	$162.88	$525.69
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $196.34 / $196.34 / $196.34	Professional	25	$196.34	$196.34	$196.34
Midlands Facility/Professional Facility Modifier Low / Median / High Price $108.69 / $156.26 / $201.28	Facility		$108.69	$156.26	$201.28
Midlands Facility/Professional Professional Modifier Low / Median / High Price $118.54 / $151.00 / $204.91	Professional		$118.54	$151.00	$204.91
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $80.13 / $139.72 / $168.77	Professional		$80.13	$139.72	$168.77
United Facility/Professional Professional Modifier Low / Median / High Price $98.57 / $162.88 / $202.12	Professional		$98.57	$162.88	$202.12
United Facility/Professional Professional Modifier 25 Low / Median / High Price $83.64 / $83.64 / $99.10	Professional	25	$83.64	$83.64	$99.10