Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $125.89 / $213.80	Facility		$85.11	$125.89	$213.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $128.82 / $181.97	Professional		$93.33	$128.82	$181.97
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $30.20 / $30.20 / $30.20	Professional	25	$30.20	$30.20	$30.20
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $128.82 / $144.54	Professional		$114.82	$128.82	$144.54
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $117.49 / $123.03 / $144.54	Professional	25	$117.49	$123.03	$144.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $245.47	Facility		$125.89	$125.89	$245.47
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $125.89 / $263.03	Professional		$100.00	$125.89	$263.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $154.88 / $194.98	Facility		$138.04	$154.88	$194.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $158.49 / $234.42	Professional		$141.25	$158.49	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $128.82 / $173.78	Professional		$109.65	$128.82	$173.78
United Facility/Professional Facility Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Facility		$109.65	$109.65	$109.65
United Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $131.83 / $194.98	Professional		$109.65	$131.83	$194.98