Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.23 / $128.82 / $363.08	Facility		$120.23	$128.82	$363.08
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $295.12 / $295.12 / $295.12	Facility	25	$295.12	$295.12	$295.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $229.09 / $446.68	Professional		$151.36	$229.09	$446.68
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $218.78 / $316.23 / $549.54	Professional	25	$218.78	$316.23	$549.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $275.42 / $354.81	Professional		$213.80	$275.42	$354.81
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $213.80 / $263.03 / $309.03	Professional	25	$213.80	$263.03	$309.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.12 / $295.12 / $295.12	Facility		$295.12	$295.12	$295.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $257.04 / $398.11	Professional		$169.82	$257.04	$398.11
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $218.78 / $275.42	Professional		$208.93	$218.78	$275.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
United Facility/Professional Facility Modifier Low / Median / High Price $154.88 / $162.18 / $162.18	Facility		$154.88	$162.18	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $213.80 / $371.54	Professional		$141.25	$213.80	$371.54
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $154.88 / $234.42	Professional		$154.88	$154.88	$234.42