Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $478.63 / $3,467.37	Facility		$316.23	$478.63	$3,467.37
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $346.74 / $3,235.94 / $3,388.44	Facility	25	$346.74	$3,235.94	$3,388.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $234.42 / $758.58	Professional		$169.82	$234.42	$758.58
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $154.88 / $316.23 / $1,202.26	Professional	25	$154.88	$316.23	$1,202.26
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $204.17 / $309.03	Professional		$165.96	$204.17	$309.03
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $162.18 / $204.17 / $363.08	Professional	25	$162.18	$204.17	$363.08
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,548.82 / $2,630.27 / $4,265.80	Facility		$1,548.82	$2,630.27	$4,265.80
BCBS Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $257.04 / $338.84	Professional		$199.53	$257.04	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $331.13 / $331.13	Facility		$331.13	$331.13	$331.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $316.23 / $489.78	Professional		$213.80	$316.23	$489.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $389.05	Professional		$32.36	$33.11	$389.05
Providence Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $295.12 / $489.78	Facility		$190.55	$295.12	$489.78
Providence Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $338.84 / $575.44	Professional		$223.87	$338.84	$575.44
United Facility/Professional Facility Modifier Low / Median / High Price $3,630.78 / $3,630.78 / $3,630.78	Facility		$3,630.78	$3,630.78	$3,630.78
United Facility/Professional Professional Modifier Low / Median / High Price $239.88 / $346.74 / $512.86	Professional		$239.88	$346.74	$512.86