Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $109.65 / $724.44	Professional		$93.33	$109.65	$724.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $131.83	Professional		$128.82	$128.82	$131.83
BCBS Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $165.96 / $165.96	Professional		$151.36	$165.96	$165.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $104.71 / $194.98	Facility		$104.71	$104.71	$194.98
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $199.53 / $295.12	Professional		$104.71	$199.53	$295.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $190.55 / $812.83	Facility		$109.65	$190.55	$812.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $173.78	Professional		$57.54	$85.11	$173.78
Midlands Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $426.58	Professional		$190.55	$190.55	$426.58
Midlands Facility/Professional Facility Modifier Low / Median / High Price $194.98 / $194.98 / $194.98	Facility		$194.98	$194.98	$194.98
Midlands Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $426.58 / $426.58	Professional		$239.88	$426.58	$426.58
United Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $89.13 / $177.83	Facility		$58.88	$89.13	$177.83
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $85.11 / $128.82	Professional		$57.54	$85.11	$128.82