Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $21.88 / $51.29 / $263.03	Facility		$21.88	$51.29	$263.03
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $45.71 / $169.82 / $302.00	Facility	25	$45.71	$169.82	$302.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $48.98 / $109.65	Professional		$28.18	$48.98	$109.65
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $32.36 / $57.54 / $128.82	Professional	25	$32.36	$57.54	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $54.95 / $83.18	Professional		$32.36	$54.95	$83.18
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $40.74 / $54.95 / $83.18	Professional	25	$40.74	$54.95	$83.18
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $43.65 / $43.65 / $54.95	Professional	50	$43.65	$43.65	$54.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.95 / $128.82 / $190.55	Facility		$54.95	$128.82	$190.55
Cigna Facility/Professional Facility Modifier 22 Low / Median / High Price $64.57 / $64.57 / $64.57	Facility	22	$64.57	$64.57	$64.57
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $33.88 / $33.88 / $33.88	Facility	62	$33.88	$33.88	$33.88
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $5.37 / $5.37 / $5.37	Facility	AS	$5.37	$5.37	$5.37
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $46.77 / $87.10	Professional		$27.54	$46.77	$87.10
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $162.18 / $416.87	Facility		$30.20	$162.18	$416.87
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $44.67 / $151.36	Professional		$21.38	$44.67	$151.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $33.11 / $56.23	Professional		$22.39	$33.11	$56.23
United Facility/Professional Facility Modifier Low / Median / High Price $22.39 / $30.90 / $48.98	Facility		$22.39	$30.90	$48.98
United Facility/Professional Professional Modifier Low / Median / High Price $21.38 / $36.31 / $64.57	Professional		$21.38	$36.31	$64.57
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $19.05 / $28.18 / $58.88	Professional		$19.05	$28.18	$58.88