Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.39 / $64.92 / $362.49	Facility		$48.39	$64.92	$362.49
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $76.95 / $216.23 / $665.04	Facility	25	$76.95	$216.23	$665.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.40 / $79.81 / $175.58	Professional		$48.40	$79.81	$175.58
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $51.94 / $90.22 / $200.00	Professional	25	$51.94	$90.22	$200.00
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 $64.98 / $84.42 / $115.76	Professional		$64.98	$84.42	$115.76
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $70.81 / $98.39 / $116.62	Professional	25	$70.81	$98.39	$116.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.00 / $150.00 / $150.00	Facility		$112.00	$150.00	$150.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $60.00 / $93.57	Professional		$38.61	$60.00	$93.57
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.17 / $75.81 / $98.78	Facility		$61.17	$75.81	$98.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $72.79 / $95.80 / $128.28	Professional		$72.79	$95.80	$128.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $88.08 / $95.00	Facility		$85.00	$88.08	$95.00
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 $48.99 / $73.84 / $130.16	Professional		$48.99	$73.84	$130.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $31.97 / $32.34 / $108.29	Professional		$31.97	$32.34	$108.29
United Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $76.15 / $125.35	Professional		$56.97	$76.15	$125.35