Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.17 / $130.47 / $228.96	Facility		$37.17	$130.47	$228.96
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $67.23 / $147.87 / $240.53	Facility	25	$67.23	$147.87	$240.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.28 / $46.60 / $97.11	Professional		$25.28	$46.60	$97.11
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $32.82 / $55.32 / $146.77	Professional	25	$32.82	$55.32	$146.77
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.28 / $55.92 / $89.00	Professional		$35.28	$55.92	$89.00
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $47.53 / $58.75 / $88.43	Professional	25	$47.53	$58.75	$88.43
BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.20 / $106.77 / $329.72	Facility		$57.20	$106.77	$329.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.50 / $31.00 / $53.50	Professional		$25.50	$31.00	$53.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.99 / $46.99 / $238.15	Facility		$46.99	$46.99	$238.15
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $29.37 / $29.37 / $29.37	Facility	62	$29.37	$29.37	$29.37
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $4.70 / $4.70 / $4.70	Facility	AS	$4.70	$4.70	$4.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.24 / $42.93 / $80.78	Professional		$25.24	$42.93	$80.78
Medcost Facility/Professional Facility Modifier Low / Median / High Price $30.01 / $43.43 / $75.08	Facility		$30.01	$43.43	$75.08
Medcost Facility/Professional Facility Modifier 50 Low / Median / High Price $55.50 / $63.00 / $113.14	Facility	50	$55.50	$63.00	$113.14
Medcost Facility/Professional Facility Modifier 80 Low / Median / High Price $7.40 / $8.40 / $15.09	Facility	80	$7.40	$8.40	$15.09
Medcost Facility/Professional Facility Modifier AS Low / Median / High Price $5.18 / $5.88 / $10.36	Facility	AS	$5.18	$5.88	$10.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $41.00 / $54.00	Professional		$30.00	$41.00	$54.00
Medcost Facility/Professional Professional Modifier 50 Low / Median / High Price $61.50 / $61.50 / $65.90	Professional	50	$61.50	$61.50	$65.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.90 / $74.75 / $117.88	Professional		$54.90	$74.75	$117.88
United Facility/Professional Professional Modifier Low / Median / High Price $34.64 / $42.75 / $74.27	Professional		$34.64	$42.75	$74.27