Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.76 / $825.00 / $2,480.05	Facility		$92.76	$825.00	$2,480.05
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $595.20 / $2,174.17 / $2,819.96	Facility	25	$595.20	$2,174.17	$2,819.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $110.25 / $251.66	Professional		$79.43	$110.25	$251.66
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $105.91 / $280.42 / $615.37	Professional	25	$105.91	$280.42	$615.37
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.36 / $147.37 / $425.19	Professional		$113.36	$147.37	$425.19
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $113.36 / $147.37 / $340.08	Professional	25	$113.36	$147.37	$340.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $607.00 / $2,250.00 / $2,812.00	Facility		$607.00	$2,250.00	$2,812.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.21 / $113.08 / $225.00	Professional		$87.21	$113.08	$225.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $113.36 / $139.72 / $181.38	Facility		$113.36	$139.72	$181.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.36 / $141.69 / $187.04	Professional		$113.36	$141.69	$187.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.63 / $139.63 / $139.63	Facility		$139.63	$139.63	$139.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $103.53 / $146.00 / $235.35	Professional		$103.53	$146.00	$235.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $147.37	Professional		$32.34	$32.34	$147.37
United Facility/Professional Professional Modifier Low / Median / High Price $97.49 / $124.90 / $207.95	Professional		$97.49	$124.90	$207.95