Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $23.44 / $42.66 / $190.55	Facility		$23.44	$42.66	$190.55
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $53.70 / $186.21 / $338.84	Facility	25	$53.70	$186.21	$338.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $52.48 / $109.65	Professional		$28.84	$52.48	$109.65
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $32.36 / $57.54 / $125.89	Professional	25	$32.36	$57.54	$125.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $31.62 / $52.48 / $75.86	Professional		$31.62	$52.48	$75.86
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $39.81 / $53.70 / $75.86	Professional	25	$39.81	$53.70	$75.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $36.31 / $50.12	Professional		$23.99	$36.31	$50.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $39.81 / $54.95	Facility		$32.36	$39.81	$54.95
CareSource Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $58.88 / $75.86	Professional		$42.66	$58.88	$75.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $54.95 / $54.95	Facility		$28.84	$54.95	$54.95
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 $26.92 / $45.71 / $263.03	Professional		$26.92	$45.71	$263.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.42 / $32.36 / $72.44	Professional		$20.42	$32.36	$72.44
United Facility/Professional Professional Modifier Low / Median / High Price $22.39 / $36.31 / $57.54	Professional		$22.39	$36.31	$57.54