Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $165.96 / $234.42	Facility		$134.90	$165.96	$234.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $204.17 / $436.52	Professional		$144.54	$204.17	$436.52
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $257.04 / $389.05	Professional		$173.78	$257.04	$389.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $275.42 / $275.42	Facility		$173.78	$275.42	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $245.47 / $426.58	Professional		$173.78	$245.47	$426.58
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $229.09 / $229.09 / $229.09	Facility		$229.09	$229.09	$229.09
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $204.17 / $269.15	Professional		$114.82	$204.17	$269.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $181.97 / $309.03	Professional		$33.11	$181.97	$309.03
United Facility/Professional Facility Modifier Low / Median / High Price $0.23 / $158.49 / $218.78	Facility		$0.23	$158.49	$218.78
United Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $208.93 / $346.74	Professional		$147.91	$208.93	$346.74
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $158.49 / $208.93	Professional		$138.04	$158.49	$208.93