Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $107.15 / $134.90	Facility		$102.33	$107.15	$134.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $120.23 / $190.55	Professional		$100.00	$120.23	$190.55
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $128.82 / $128.82 / $128.82	Professional	25	$128.82	$128.82	$128.82
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $123.03 / $147.91	Professional		$104.71	$123.03	$147.91
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $100.00 / $117.49 / $128.82	Professional	25	$100.00	$117.49	$128.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $186.21 / $346.74	Professional		$97.72	$186.21	$346.74
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $102.33 / $134.90	Professional		$100.00	$102.33	$134.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.84 / $32.36 / $33.11	Professional		$28.84	$32.36	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $104.71	Facility		$100.00	$100.00	$104.71
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $134.90 / $245.47	Professional		$95.50	$134.90	$245.47
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $102.33 / $102.33	Professional		$102.33	$102.33	$102.33