Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.08 / $92.08 / $241.58	Facility		$63.08	$92.08	$241.58
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $103.57 / $180.60 / $856.57	Facility	25	$103.57	$180.60	$856.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.36 / $114.55 / $264.38	Professional		$66.36	$114.55	$264.38
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $65.70 / $132.03 / $309.00	Professional	25	$65.70	$132.03	$309.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $94.50 / $94.50 / $94.50	Professional	50	$94.50	$94.50	$94.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.39 / $120.16 / $164.64	Professional		$92.39	$120.16	$164.64
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $106.73 / $147.00 / $164.64	Professional	25	$106.73	$147.00	$164.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.00 / $112.00 / $112.00	Facility		$112.00	$112.00	$112.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.37 / $83.22 / $137.41	Professional		$56.37	$83.22	$137.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $90.08 / $112.60 / $145.47	Facility		$90.08	$112.60	$145.47
CareSource Facility/Professional Professional Modifier Low / Median / High Price $108.10 / $135.24 / $181.10	Professional		$108.10	$135.24	$181.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $129.72 / $129.72	Facility		$85.00	$129.72	$129.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $112.00 / $190.89	Professional		$74.34	$112.00	$190.89
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $46.48 / $152.00	Professional		$32.34	$46.48	$152.00
United Facility/Professional Professional Modifier Low / Median / High Price $85.31 / $110.43 / $168.43	Professional		$85.31	$110.43	$168.43