Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.05 / $45.63 / $207.53	Facility		$31.05	$45.63	$207.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.19 / $62.75 / $142.34	Professional		$35.19	$62.75	$142.34
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $55.00 / $93.12 / $260.94	Professional	25	$55.00	$93.12	$260.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $47.03 / $65.78 / $90.77	Professional		$47.03	$65.78	$90.77
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $60.90 / $73.81 / $89.78	Professional	25	$60.90	$73.81	$89.78
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $150.00 / $150.00 / $150.00	Facility		$150.00	$150.00	$150.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.01 / $62.29 / $93.04	Professional		$43.01	$62.29	$93.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.50 / $53.89 / $70.26	Facility		$43.50	$53.89	$70.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $53.83 / $74.81 / $100.19	Professional		$53.83	$74.81	$100.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.64 / $62.64 / $95.00	Facility		$62.64	$62.64	$95.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $69.55 / $121.31	Professional		$45.00	$69.55	$121.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $84.58	Professional		$32.34	$32.34	$84.58
United Facility/Professional Professional Modifier Low / Median / High Price $59.47 / $76.56 / $121.31	Professional		$59.47	$76.56	$121.31