Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $120.23 / $218.78	Facility		$114.82	$120.23	$218.78
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $208.93 / $223.87 / $223.87	Facility	25	$208.93	$223.87	$223.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $234.42 / $478.63	Professional		$151.36	$234.42	$478.63
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $245.47 / $354.81 / $562.34	Professional	25	$245.47	$354.81	$562.34
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $281.84 / $416.87	Professional		$218.78	$281.84	$416.87
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $223.87 / $281.84 / $478.63	Professional	25	$223.87	$281.84	$478.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $245.47 / $354.81	Professional		$177.83	$245.47	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $138.04 / $204.17 / $302.00	Facility		$138.04	$204.17	$302.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $407.38	Professional		$263.03	$263.03	$407.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $281.84 / $478.63	Professional		$186.21	$281.84	$478.63
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $169.82 / $302.00 / $602.56	Professional		$169.82	$302.00	$602.56
United Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $251.19 / $489.78	Professional		$162.18	$251.19	$489.78