Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.00 / $89.00 / $113.24	Facility		$89.00	$89.00	$113.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.10 / $65.31 / $113.88	Professional		$41.10	$65.31	$113.88
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $35.20 / $75.95 / $233.00	Professional	25	$35.20	$75.95	$233.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $44.21 / $66.59 / $145.19	Professional		$44.21	$66.59	$145.19
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $53.28 / $60.63 / $67.66	Professional	25	$53.28	$60.63	$67.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.47 / $66.87 / $87.38	Professional		$40.47	$66.87	$87.38
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.64 / $140.00 / $175.00	Facility		$62.64	$140.00	$175.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.34 / $80.56 / $121.68	Professional		$55.34	$80.56	$121.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $108.90	Professional		$32.34	$32.34	$108.90
Providence Facility/Professional Facility Modifier Low / Median / High Price $42.62 / $66.81 / $91.40	Facility		$42.62	$66.81	$91.40
Providence Facility/Professional Professional Modifier Low / Median / High Price $56.27 / $87.35 / $141.00	Professional		$56.27	$87.35	$141.00
United Facility/Professional Professional Modifier Low / Median / High Price $73.56 / $105.95 / $173.01	Professional		$73.56	$105.95	$173.01