Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $77.62 / $151.36	Facility		$57.54	$77.62	$151.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $91.20 / $165.96	Professional		$64.57	$91.20	$165.96
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $87.10 / $87.10 / $91.20	Professional	25	$87.10	$87.10	$91.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $109.65	Professional		$79.43	$93.33	$109.65
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $83.18 / $87.10 / $104.71	Professional	25	$83.18	$87.10	$104.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $165.96	Facility		$85.11	$85.11	$165.96
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $85.11 / $177.83	Professional		$72.44	$85.11	$177.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $109.65 / $138.04	Facility		$95.50	$109.65	$138.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $112.20 / $162.18	Professional		$100.00	$112.20	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $93.33 / $134.90	Professional		$79.43	$93.33	$134.90
United Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $75.86	Facility		$75.86	$75.86	$75.86
United Facility/Professional Professional Modifier Low / Median / High Price $74.13 / $91.20 / $134.90	Professional		$74.13	$91.20	$134.90