Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $134.90 / $213.80	Professional		$107.15	$134.90	$213.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $165.96 / $186.21	Professional		$154.88	$165.96	$186.21
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $144.54 / $144.54 / $144.54	Professional	25	$144.54	$144.54	$144.54
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $173.78 / $281.84	Professional		$144.54	$173.78	$281.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $169.82 / $190.55	Facility		$165.96	$169.82	$190.55
CareSource Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $173.78 / $173.78	Professional		$169.82	$173.78	$173.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $194.98 / $302.00	Facility		$154.88	$194.98	$302.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $165.96 / $269.15	Professional		$138.04	$165.96	$269.15
United Facility/Professional Professional Modifier Low / Median / High Price $144.54 / $177.83 / $251.19	Professional		$144.54	$177.83	$251.19