Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $380.19	Facility		$97.72	$97.72	$380.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $97.72 / $107.15	Professional		$75.86	$97.72	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $97.72 / $107.15	Professional		$75.86	$97.72	$107.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Facility		$95.50	$95.50	$95.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $95.50	Professional		$95.50	$95.50	$95.50
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Facility		$97.72	$97.72	$97.72
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $87.10 / $87.10 / $97.72	Professional		$87.10	$87.10	$97.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $151.36 / $151.36	Professional		$151.36	$151.36	$151.36
United Facility/Professional Facility Modifier Low / Median / High Price $83.18 / $93.33 / $147.91	Facility		$83.18	$93.33	$147.91
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $97.72 / $114.82	Professional		$93.33	$97.72	$114.82
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $97.72	Professional		$97.72	$97.72	$97.72