Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.48 / $52.68 / $61.97	Facility		$46.48	$52.68	$61.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.48 / $61.97 / $78.06	Professional		$46.48	$61.97	$78.06
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $14.48 / $70.06 / $76.20	Professional	25	$14.48	$70.06	$76.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $104.94 / $104.94 / $123.46	Professional		$104.94	$104.94	$123.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.23 / $71.27 / $176.40	Professional		$55.23	$71.27	$176.40
Medcost Facility/Professional Facility Modifier Low / Median / High Price $52.67 / $67.15 / $83.66	Facility		$52.67	$67.15	$83.66
Medcost Facility/Professional Professional Modifier Low / Median / High Price $58.43 / $58.43 / $58.43	Professional		$58.43	$58.43	$58.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.54 / $74.17 / $82.76	Professional		$63.54	$74.17	$82.76
United Facility/Professional Professional Modifier Low / Median / High Price $58.17 / $70.84 / $116.36	Professional		$58.17	$70.84	$116.36