Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.97 / $130.06 / $159.78	Facility		$103.97	$130.06	$159.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $118.14 / $171.72 / $296.95	Professional		$118.14	$171.72	$296.95
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $151.30 / $261.83 / $375.00	Professional	25	$151.30	$261.83	$375.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.97 / $232.35 / $304.43	Professional		$165.97	$232.35	$304.43
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $182.57 / $248.95 / $304.43	Professional	25	$182.57	$248.95	$304.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $141.60 / $201.30 / $281.72	Professional		$141.60	$201.30	$281.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $161.82 / $199.16 / $248.96	Facility		$161.82	$199.16	$248.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $202.95 / $243.54 / $304.43	Professional		$202.95	$243.54	$304.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $115.00 / $162.00 / $242.44	Facility		$115.00	$162.00	$242.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.91 / $207.58 / $324.86	Professional		$151.91	$207.58	$324.86
United Facility/Professional Professional Modifier Low / Median / High Price $170.31 / $202.83 / $287.14	Professional		$170.31	$202.83	$287.14
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $88.00 / $88.00	Professional	25	$80.00	$88.00	$88.00