Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $104.71 / $173.78 / $257.04	Facility		$104.71	$173.78	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $158.49 / $245.47	Professional		$112.20	$158.49	$245.47
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $501.19 / $501.19 / $501.19	Professional	25	$501.19	$501.19	$501.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $158.49 / $186.21	Professional		$134.90	$158.49	$186.21
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $134.90 / $158.49 / $186.21	Professional	25	$134.90	$158.49	$186.21
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $154.88 / $302.00	Facility		$154.88	$154.88	$302.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $154.88 / $316.23	Professional		$120.23	$154.88	$316.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $162.18 / $186.21 / $234.42	Facility		$162.18	$186.21	$234.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $190.55 / $275.42	Professional		$165.96	$190.55	$275.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $169.82 / $245.47	Professional		$120.23	$169.82	$245.47
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $128.82	Facility		$128.82	$128.82	$128.82
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $162.18 / $234.42	Professional		$128.82	$162.18	$234.42