Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $113.43 / $158.72 / $492.95	Facility		$113.43	$158.72	$492.95
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $21.55 / $21.55 / $470.59	Facility	25	$21.55	$21.55	$470.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $111.56 / $162.63 / $317.39	Professional		$111.56	$162.63	$317.39
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $164.01 / $232.77 / $407.55	Professional	25	$164.01	$232.77	$407.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $157.25 / $201.58 / $342.33	Professional		$157.25	$201.58	$342.33
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $250.00 / $374.25 / $385.02	Professional	25	$250.00	$374.25	$385.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.73 / $183.40 / $300.14	Professional		$123.73	$183.40	$300.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $98.22 / $141.57 / $215.73	Facility		$98.22	$141.57	$215.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $189.51 / $190.05 / $300.33	Professional		$189.51	$190.05	$300.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $130.16 / $195.00 / $315.32	Professional		$130.16	$195.00	$315.32
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $134.83 / $201.58 / $297.08	Professional		$134.83	$201.58	$297.08
United Facility/Professional Professional Modifier Low / Median / High Price $150.13 / $211.27 / $410.06	Professional		$150.13	$211.27	$410.06