Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.75 / $73.81 / $93.73	Professional		$42.75	$73.81	$93.73
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $76.23 / $98.35 / $192.97	Professional	25	$76.23	$98.35	$192.97
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.09 / $78.59 / $110.03	Professional		$73.09	$78.59	$110.03
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $57.10 / $57.10 / $57.10	Professional	25	$57.10	$57.10	$57.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $30.92 / $48.29 / $100.68	Professional		$30.92	$48.29	$100.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.68 / $50.25 / $66.23	Facility		$45.68	$50.25	$66.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $66.23 / $80.56 / $110.03	Professional		$66.23	$80.56	$110.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.94 / $79.94 / $79.94	Facility		$79.94	$79.94	$79.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $68.48 / $128.15	Professional		$39.93	$68.48	$128.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $46.92	Professional		$32.34	$32.34	$46.92
United Facility/Professional Professional Modifier Low / Median / High Price $50.68 / $69.75 / $105.98	Professional		$50.68	$69.75	$105.98