Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $64.57 / $117.49	Professional		$38.02	$64.57	$117.49
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $75.86 / $89.13 / $263.03	Professional	25	$75.86	$89.13	$263.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $77.62 / $81.28	Professional		$70.79	$77.62	$81.28
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $72.44 / $72.44 / $72.44	Professional	25	$72.44	$72.44	$72.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $45.71 / $112.20	Professional		$29.51	$45.71	$112.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.69 / $51.29 / $61.66	Facility		$41.69	$51.29	$61.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $77.62 / $104.71	Professional		$57.54	$77.62	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $72.44 / $389.05	Professional		$42.66	$72.44	$389.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $51.29	Professional		$32.36	$33.11	$51.29
United Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $54.95 / $85.11	Professional		$37.15	$54.95	$85.11