Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Facility		$223.87	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $57.54 / $107.15	Professional		$41.69	$57.54	$107.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $58.88 / $85.11	Professional		$50.12	$58.88	$85.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $72.44 / $72.44	Facility		$72.44	$72.44	$72.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $67.61 / $123.03	Professional		$47.86	$67.61	$123.03
Medcost Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $83.18 / $104.71	Professional		$66.07	$83.18	$104.71
Medcost Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $67.61 / $109.65	Facility		$44.67	$67.61	$109.65
Medcost Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $39.81 / $39.81	Professional		$39.81	$39.81	$39.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.18 / $41.69 / $58.88	Professional		$28.18	$41.69	$58.88
United Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $58.88 / $89.13	Professional		$43.65	$58.88	$89.13