Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $394.80 / $677.16 / $866.68	Facility		$394.80	$677.16	$866.68
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $394.80 / $406.60 / $875.90	Facility	25	$394.80	$406.60	$875.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.88 / $66.00 / $102.73	Professional		$50.88	$66.00	$102.73
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $68.09 / $148.44 / $367.20	Professional	25	$68.09	$148.44	$367.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $65.37 / $67.29 / $112.27	Professional		$65.37	$67.29	$112.27
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.29 / $67.29 / $67.29	Professional	25	$67.29	$67.29	$67.29
BCBS Facility/Professional Facility Modifier Low / Median / High Price $652.90 / $771.02 / $1,219.78	Facility		$652.90	$771.02	$1,219.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.13 / $70.70 / $120.05	Professional		$59.13	$70.70	$120.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.49 / $91.04 / $131.16	Professional		$61.49	$91.04	$131.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $113.89	Professional		$32.34	$32.34	$113.89
Providence Facility/Professional Facility Modifier Low / Median / High Price $60.07 / $80.92 / $126.10	Facility		$60.07	$80.92	$126.10
Providence Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $97.27 / $178.82	Professional		$67.40	$97.27	$178.82
United Facility/Professional Professional Modifier Low / Median / High Price $70.18 / $91.99 / $139.04	Professional		$70.18	$91.99	$139.04