Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.75 / $188.30 / $620.00	Facility		$133.75	$188.30	$620.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.34 / $142.99 / $316.75	Professional		$103.34	$142.99	$316.75
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $90.00 / $186.69 / $479.00	Professional	25	$90.00	$186.69	$479.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $136.04 / $170.89 / $224.27	Professional		$136.04	$170.89	$224.27
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $136.04 / $180.72 / $261.80	Professional	25	$136.04	$180.72	$261.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.68 / $141.22 / $225.52	Professional		$77.68	$141.22	$225.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $140.00 / $175.00 / $191.64	Facility		$140.00	$175.00	$191.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $121.51 / $179.63 / $261.49	Professional		$121.51	$179.63	$261.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $154.33 / $276.45	Professional		$32.34	$154.33	$276.45
Providence Facility/Professional Facility Modifier Low / Median / High Price $103.34 / $148.22 / $187.77	Facility		$103.34	$148.22	$187.77
Providence Facility/Professional Professional Modifier Low / Median / High Price $121.51 / $200.47 / $369.74	Professional		$121.51	$200.47	$369.74
United Facility/Professional Professional Modifier Low / Median / High Price $153.12 / $201.39 / $300.02	Professional		$153.12	$201.39	$300.02