Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $190.55 / $190.55	Facility		$169.82	$190.55	$190.55
Aetna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $190.55	Professional		$162.18	$162.18	$190.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $190.55	Professional		$169.82	$169.82	$190.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
United Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $181.97 / $288.40	Facility		$162.18	$181.97	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $169.82 / $204.17	Professional		$169.82	$169.82	$204.17
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55