Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $779.00 / $802.76 / $870.24	Facility		$779.00	$802.76	$870.24
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $735.08 / $923.08 / $1,953.00	Facility	25	$735.08	$923.08	$1,953.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.69 / $119.45 / $177.50	Professional		$91.69	$119.45	$177.50
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $24.19 / $375.00 / $725.40	Professional	25	$24.19	$375.00	$725.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $113.36 / $250.85 / $428.50	Professional		$113.36	$250.85	$428.50
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $114.81 / $114.81 / $114.81	Professional	25	$114.81	$114.81	$114.81
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,039.44 / $1,227.48 / $1,941.91	Facility		$1,039.44	$1,227.48	$1,941.91
BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.17 / $120.35 / $212.16	Professional		$108.17	$120.35	$212.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.63 / $166.47 / $221.15	Professional		$105.63	$166.47	$221.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $193.87	Professional		$32.34	$32.34	$193.87
Providence Facility/Professional Facility Modifier Low / Median / High Price $98.94 / $142.76 / $189.15	Facility		$98.94	$142.76	$189.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $114.81 / $179.17 / $312.02	Professional		$114.81	$179.17	$312.02
United Facility/Professional Professional Modifier Low / Median / High Price $131.47 / $165.88 / $246.73	Professional		$131.47	$165.88	$246.73