Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.90 / $122.00 / $122.00	Facility		$118.90	$122.00	$122.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $59.45 / $59.45 / $59.45	Facility	25	$59.45	$59.45	$59.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.65 / $106.56 / $244.61	Professional		$67.65	$106.56	$244.61
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $50.88 / $124.21 / $311.60	Professional	25	$50.88	$124.21	$311.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $92.01 / $121.66 / $197.57	Professional		$92.01	$121.66	$197.57
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $94.08 / $121.66 / $152.08	Professional	25	$94.08	$121.66	$152.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.79 / $96.31 / $161.97	Professional		$57.79	$96.31	$161.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.72 / $140.00 / $175.00	Facility		$129.72	$140.00	$175.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $86.04 / $127.19 / $191.54	Professional		$86.04	$127.19	$191.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $109.31 / $196.68	Professional		$32.34	$109.31	$196.68
Providence Facility/Professional Facility Modifier Low / Median / High Price $67.19 / $105.82 / $136.38	Facility		$67.19	$105.82	$136.38
Providence Facility/Professional Professional Modifier Low / Median / High Price $84.50 / $142.56 / $256.97	Professional		$84.50	$142.56	$256.97
United Facility/Professional Professional Modifier Low / Median / High Price $105.27 / $143.83 / $215.34	Professional		$105.27	$143.83	$215.34