Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.21 / $120.34 / $255.80	Facility		$86.21	$120.34	$255.80
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $45.00 / $781.63 / $781.63	Facility	25	$45.00	$781.63	$781.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.15 / $165.02 / $383.54	Professional		$97.15	$165.02	$383.54
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $114.56 / $200.68 / $518.29	Professional	25	$114.56	$200.68	$518.29
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.34 / $164.65 / $215.43	Professional		$134.34	$164.65	$215.43
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $153.88 / $196.55 / $215.43	Professional	25	$153.88	$196.55	$215.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.54 / $130.79 / $211.16	Professional		$94.54	$130.79	$211.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.81 / $154.76 / $199.96	Facility		$123.81	$154.76	$199.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.33 / $176.96 / $246.21	Professional		$147.33	$176.96	$246.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $178.29 / $178.29	Facility		$85.00	$178.29	$178.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.35 / $164.00 / $270.52	Professional		$117.35	$164.00	$270.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $80.17 / $152.00	Professional		$32.34	$80.17	$152.00
United Facility/Professional Facility Modifier Low / Median / High Price $188.95 / $188.95 / $188.95	Facility		$188.95	$188.95	$188.95
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $162.65 / $262.33	Professional		$131.83	$162.65	$262.33