Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.59 / $123.45 / $260.25	Facility		$92.59	$123.45	$260.25
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $574.64 / $574.64 / $574.64	Facility	25	$574.64	$574.64	$574.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.94 / $151.62 / $369.13	Professional		$93.94	$151.62	$369.13
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $119.55 / $238.55 / $522.78	Professional	25	$119.55	$238.55	$522.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $141.40 / $183.65 / $231.59	Professional		$141.40	$183.65	$231.59
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $165.42 / $194.04 / $229.13	Professional	25	$165.42	$194.04	$229.13
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 $83.92 / $119.30 / $187.62	Professional		$83.92	$119.30	$187.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $133.08 / $165.05 / $214.93	Facility		$133.08	$165.05	$214.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.37 / $190.95 / $264.67	Professional		$158.37	$190.95	$264.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $85.00 / $191.64 / $191.64	Facility		$85.00	$191.64	$191.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $106.74 / $155.86 / $260.64	Professional		$106.74	$155.86	$260.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $65.37 / $152.00	Professional		$32.34	$65.37	$152.00
United Facility/Professional Professional Modifier Low / Median / High Price $115.67 / $147.44 / $229.28	Professional		$115.67	$147.44	$229.28