Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.10 / $271.10 / $293.36	Facility		$185.10	$271.10	$293.36
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,392.70 / $1,392.70 / $1,392.70	Facility	25	$1,392.70	$1,392.70	$1,392.70
Aetna Facility/Professional Professional Modifier Low / Median / High Price $136.97 / $195.43 / $455.15	Professional		$136.97	$195.43	$455.15
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $156.35 / $253.13 / $489.46	Professional	25	$156.35	$253.13	$489.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $169.15 / $221.20 / $368.33	Professional		$169.15	$221.20	$368.33
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $174.90 / $221.20 / $368.33	Professional	25	$174.90	$221.20	$368.33
BCBS Facility/Professional Facility Modifier Low / Median / High Price $248.86 / $300.54 / $730.27	Facility		$248.86	$300.54	$730.27
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.00 / $135.00 / $210.27	Professional		$125.00	$135.00	$210.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $242.44 / $242.44	Facility		$95.00	$242.44	$242.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.66 / $210.35 / $351.34	Professional		$151.66	$210.35	$351.34
Medcost Facility/Professional Facility Modifier Low / Median / High Price $153.00 / $206.44 / $354.69	Facility		$153.00	$206.44	$354.69
Medcost Facility/Professional Professional Modifier Low / Median / High Price $115.00 / $188.00 / $254.00	Professional		$115.00	$188.00	$254.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $188.91 / $261.57 / $415.03	Professional		$188.91	$261.57	$415.03
United Facility/Professional Professional Modifier Low / Median / High Price $160.19 / $199.27 / $363.29	Professional		$160.19	$199.27	$363.29
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $88.00	Professional	25	$80.00	$80.00	$88.00