Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.75 / $75.64 / $88.99	Facility		$66.75	$75.64	$88.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.75 / $87.62 / $113.98	Professional		$66.75	$87.62	$113.98
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $20.57 / $101.95 / $101.95	Professional	25	$20.57	$101.95	$101.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $152.29 / $152.29 / $179.16	Professional		$152.29	$152.29	$179.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.64 / $94.09 / $228.22	Professional		$73.64	$94.09	$228.22
Medcost Facility/Professional Facility Modifier Low / Median / High Price $75.64 / $90.65 / $120.14	Facility		$75.64	$90.65	$120.14
Medcost Facility/Professional Professional Modifier Low / Median / High Price $77.47 / $77.47 / $77.47	Professional		$77.47	$77.47	$77.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $112.41 / $123.48	Professional		$96.53	$112.41	$123.48
United Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $92.33 / $174.00	Professional		$69.84	$92.33	$174.00