Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.01 / $108.81 / $128.01	Facility		$96.01	$108.81	$128.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.92 / $123.62 / $156.36	Professional		$102.92	$123.62	$156.36
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $24.50 / $68.90 / $175.00	Professional	25	$24.50	$68.90	$175.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $217.29 / $217.29 / $255.63	Professional		$217.29	$217.29	$255.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.19 / $134.13 / $178.50	Professional		$108.19	$134.13	$178.50
Medcost Facility/Professional Facility Modifier Low / Median / High Price $108.81 / $128.01 / $172.81	Facility		$108.81	$128.01	$172.81
Medcost Facility/Professional Professional Modifier Low / Median / High Price $115.23 / $115.23 / $115.23	Professional		$115.23	$115.23	$115.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $160.08 / $186.00 / $206.24	Professional		$160.08	$186.00	$206.24
United Facility/Professional Professional Modifier Low / Median / High Price $103.19 / $135.90 / $251.00	Professional		$103.19	$135.90	$251.00