Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $389.05 / $1,659.59	Facility		$77.62	$389.05	$1,659.59
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $457.09 / $1,258.93 / $2,570.40	Facility	25	$457.09	$1,258.93	$2,570.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $128.82 / $741.31	Professional		$91.20	$128.82	$741.31
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $97.72 / $257.04 / $812.83	Professional	25	$97.72	$257.04	$812.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $128.82 / $204.17	Professional		$102.33	$128.82	$204.17
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $112.20 / $141.25 / $213.80	Professional	25	$112.20	$141.25	$213.80
BCBS Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $707.95 / $891.25	Facility		$457.09	$707.95	$891.25
BCBS Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $120.23 / $141.25	Professional		$114.82	$120.23	$141.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $128.82 / $229.09	Professional		$104.71	$128.82	$229.09
Medcost Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $125.89 / $151.36	Professional		$125.89	$125.89	$151.36
Medcost Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $147.91 / $275.42	Facility		$112.20	$147.91	$275.42
Medcost Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Professional		$114.82	$114.82	$114.82
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 $2,691.53 / $2,691.53 / $2,691.53	Facility		$2,691.53	$2,691.53	$2,691.53
United Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $114.82 / $190.55	Professional		$97.72	$114.82	$190.55