Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $131.83 / $162.18	Facility		$131.83	$131.83	$162.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $70.79 / $169.82	Professional		$57.54	$70.79	$169.82
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $56.23 / $138.04 / $457.09	Professional	25	$56.23	$138.04	$457.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $75.86 / $75.86	Professional		$69.18	$75.86	$75.86
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $89.13 / $89.13 / $89.13	Professional	25	$89.13	$89.13	$89.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $269.15 / $363.08	Facility		$147.91	$269.15	$363.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $104.71 / $144.54	Professional		$63.10	$104.71	$144.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $120.23 / $190.55	Professional		$67.61	$120.23	$190.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $85.11 / $125.89	Facility		$57.54	$85.11	$125.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $141.25 / $457.09	Professional		$79.43	$141.25	$457.09
Midlands Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $141.25 / $169.82	Professional		$102.33	$141.25	$169.82
Midlands Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $138.04 / $169.82	Professional		$114.82	$138.04	$169.82
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $181.97	Professional		$102.33	$102.33	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $0.08 / $0.08 / $0.08	Facility		$0.08	$0.08	$0.08
United Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $109.65 / $169.82	Professional		$70.79	$109.65	$169.82