Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $158.49 / $275.42	Facility		$117.49	$158.49	$275.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $154.88 / $218.78	Professional		$117.49	$154.88	$218.78
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $239.88 / $239.88 / $239.88	Professional	25	$239.88	$239.88	$239.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $162.18 / $234.42	Professional		$138.04	$162.18	$234.42
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $138.04 / $144.54 / $169.82	Professional	25	$138.04	$144.54	$169.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $120.23 / $177.83	Professional		$102.33	$120.23	$177.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $199.53 / $269.15	Facility		$165.96	$199.53	$269.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $199.53 / $269.15	Professional		$169.82	$199.53	$269.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $281.84 / $281.84 / $281.84	Facility		$281.84	$281.84	$281.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $851.14 / $851.14	Professional		$204.17	$851.14	$851.14
United Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $144.54 / $229.09	Professional		$128.82	$144.54	$229.09