Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.46 / $63.04 / $301.80	Facility		$40.46	$63.04	$301.80
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $84.79 / $138.90 / $297.75	Facility	25	$84.79	$138.90	$297.75
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $70.81 / $123.00	Professional		$43.95	$70.81	$123.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $47.50 / $82.50 / $133.72	Professional	25	$47.50	$82.50	$133.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $254.64 / $262.68 / $271.76	Professional	50	$254.64	$262.68	$271.76
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.62 / $84.46 / $125.82	Professional		$60.62	$84.46	$125.82
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $69.61 / $92.27 / $125.82	Professional	25	$69.61	$92.27	$125.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $106.95 / $125.82 / $125.82	Professional	50	$106.95	$125.82	$125.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $73.92 / $111.24	Professional		$45.00	$73.92	$111.24
Anthem BCBS Facility/Professional Professional Modifier 25 Low / Median / High Price $48.96 / $48.96 / $48.96	Professional	25	$48.96	$48.96	$48.96
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.11 / $72.73 / $90.93	Facility		$59.11	$72.73	$90.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $83.88 / $99.96 / $125.82	Professional		$83.88	$99.96	$125.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.00 / $88.08 / $120.00	Facility		$75.00	$88.08	$120.00
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $55.05 / $55.05 / $55.05	Facility	62	$55.05	$55.05	$55.05
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $8.81 / $8.81 / $8.81	Facility	AS	$8.81	$8.81	$8.81
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.43 / $74.51 / $121.61	Professional		$43.43	$74.51	$121.61
United Facility/Professional Professional Modifier Low / Median / High Price $58.64 / $73.52 / $103.29	Professional		$58.64	$73.52	$103.29