Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.56 / $80.62 / $170.90	Facility		$53.56	$80.62	$170.90
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $109.16 / $131.01 / $493.73	Facility	25	$109.16	$131.01	$493.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.80 / $101.89 / $256.07	Professional		$60.80	$101.89	$256.07
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $74.50 / $132.24 / $354.00	Professional	25	$74.50	$132.24	$354.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.04 / $106.47 / $143.01	Professional		$84.04	$106.47	$143.01
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $92.91 / $127.69 / $141.15	Professional	25	$92.91	$127.69	$141.15
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 $64.66 / $93.20 / $137.74	Professional		$64.66	$93.20	$137.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.05 / $94.24 / $122.82	Facility		$76.05	$94.24	$122.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.50 / $117.47 / $157.31	Professional		$90.50	$117.47	$157.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $109.51 / $109.51	Facility		$85.00	$109.51	$109.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.43 / $106.06 / $181.77	Professional		$73.43	$106.06	$181.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $47.24 / $132.80	Professional		$32.34	$47.24	$132.80
United Facility/Professional Professional Modifier Low / Median / High Price $85.76 / $106.48 / $167.95	Professional		$85.76	$106.48	$167.95