Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.98 / $129.36 / $288.00	Facility		$89.98	$129.36	$288.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $236.10 / $236.10 / $236.10	Facility	25	$236.10	$236.10	$236.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $107.94 / $143.72 / $235.11	Professional		$107.94	$143.72	$235.11
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $216.61 / $240.52 / $355.50	Professional	25	$216.61	$240.52	$355.50
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $167.80 / $201.37 / $335.43	Professional		$167.80	$201.37	$335.43
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $125.87 / $167.80 / $212.30	Professional	25	$125.87	$167.80	$212.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.25 / $180.47 / $289.02	Professional		$117.25	$180.47	$289.02
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $138.19 / $143.65 / $177.68	Professional		$138.19	$143.65	$177.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $155.10 / $235.32 / $390.60	Professional		$155.10	$235.32	$390.60
United Facility/Professional Professional Modifier Low / Median / High Price $128.97 / $176.81 / $308.58	Professional		$128.97	$176.81	$308.58
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $114.57 / $171.72 / $171.72	Professional		$114.57	$171.72	$171.72