Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.40 / $129.65 / $152.53	Facility		$114.40	$129.65	$152.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $121.42 / $152.53 / $203.08	Professional		$121.42	$152.53	$203.08
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $240.88 / $240.88 / $240.88	Professional	25	$240.88	$240.88	$240.88
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $302.92 / $302.92 / $302.92	Professional		$302.92	$302.92	$302.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.65 / $172.86 / $395.80	Professional		$123.65	$172.86	$395.80
Medcost Facility/Professional Facility Modifier Low / Median / High Price $128.62 / $152.53 / $205.92	Facility		$128.62	$152.53	$205.92
Medcost Facility/Professional Professional Modifier Low / Median / High Price $141.83 / $141.83 / $141.83	Professional		$141.83	$141.83	$141.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $193.07 / $224.82 / $246.96	Professional		$193.07	$224.82	$246.96
United Facility/Professional Professional Modifier Low / Median / High Price $128.38 / $166.48 / $300.00	Professional		$128.38	$166.48	$300.00