Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.29 / $218.78 / $1,096.48	Facility		$51.29	$218.78	$1,096.48
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $645.65 / $851.14 / $1,122.02	Facility	25	$645.65	$851.14	$1,122.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $70.79 / $501.19	Professional		$52.48	$70.79	$501.19
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $63.10 / $208.93 / $524.81	Professional	25	$63.10	$208.93	$524.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $81.28 / $125.89	Professional		$66.07	$81.28	$125.89
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $66.07 / $75.86 / $120.23	Professional	25	$66.07	$75.86	$120.23
BCBS Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $426.58 / $512.86	Facility		$295.12	$426.58	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $81.28 / $89.13	Professional		$75.86	$81.28	$89.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $77.62 / $123.03	Professional		$60.26	$77.62	$123.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $77.62 / $81.28	Professional		$77.62	$77.62	$81.28
Medcost Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $85.11 / $154.88	Facility		$63.10	$85.11	$154.88
Medcost Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $85.11 / $85.11	Professional		$85.11	$85.11	$85.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility		$1,737.80	$1,737.80	$1,737.80
United Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $63.10 / $107.15	Professional		$52.48	$63.10	$107.15