Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $116.98 / $155.97 / $420.90	Facility		$116.98	$155.97	$420.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $128.27 / $194.62 / $504.27	Professional		$128.27	$194.62	$504.27
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $166.12 / $309.67 / $738.17	Professional	25	$166.12	$309.67	$738.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.00 / $229.99 / $280.88	Professional		$173.00	$229.99	$280.88
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $199.63 / $242.20 / $284.13	Professional	25	$199.63	$242.20	$284.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.18 / $169.24 / $262.41	Professional		$123.18	$169.24	$262.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $168.36 / $208.61 / $271.91	Facility		$168.36	$208.61	$271.91
CareSource Facility/Professional Professional Modifier Low / Median / High Price $193.19 / $237.39 / $325.64	Professional		$193.19	$237.39	$325.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $242.44 / $242.44	Facility		$85.00	$242.44	$242.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $153.21 / $210.00 / $348.22	Professional		$153.21	$210.00	$348.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $102.94 / $164.00	Professional		$32.34	$102.94	$164.00
United Facility/Professional Professional Modifier Low / Median / High Price $167.54 / $212.43 / $326.82	Professional		$167.54	$212.43	$326.82
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $88.00 / $88.00	Professional	25	$80.00	$88.00	$88.00