Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.29 / $118.90 / $118.90	Facility		$80.29	$118.90	$118.90
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $376.04 / $376.04 / $376.04	Facility	25	$376.04	$376.04	$376.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.39 / $151.69 / $322.56	Professional		$105.39	$151.69	$322.56
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $98.82 / $175.93 / $466.41	Professional	25	$98.82	$175.93	$466.41
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $126.50 / $163.81 / $323.60	Professional		$126.50	$163.81	$323.60
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $152.41 / $158.91 / $167.92	Professional	25	$152.41	$158.91	$167.92
BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.05 / $146.75 / $218.56	Professional		$88.05	$146.75	$218.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $175.00 / $178.29	Facility		$140.00	$175.00	$178.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $136.41 / $197.51 / $281.56	Professional		$136.41	$197.51	$281.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $257.72	Professional		$32.34	$32.34	$257.72
Providence Facility/Professional Facility Modifier Low / Median / High Price $102.36 / $156.37 / $198.35	Facility		$102.36	$156.37	$198.35
Providence Facility/Professional Professional Modifier Low / Median / High Price $134.08 / $212.60 / $354.91	Professional		$134.08	$212.60	$354.91
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 $166.68 / $229.33 / $325.83	Professional		$166.68	$229.33	$325.83