Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $164.56 / $221.70 / $284.27	Facility		$164.56	$221.70	$284.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $147.75 / $214.88 / $379.76	Professional		$147.75	$214.88	$379.76
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $52.52 / $316.98 / $853.00	Professional	25	$52.52	$316.98	$853.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $186.31 / $281.22 / $360.61	Professional		$186.31	$281.22	$360.61
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $250.00 / $254.50 / $254.50	Professional	25	$250.00	$254.50	$254.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $157.03 / $185.79 / $263.02	Professional		$157.03	$185.79	$263.02
CareSource Facility/Professional Facility Modifier Low / Median / High Price $131.51 / $173.48 / $245.49	Facility		$131.51	$173.48	$245.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $204.11 / $254.50 / $356.30	Professional		$204.11	$254.50	$356.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $252.50 / $252.50 / $252.50	Facility		$252.50	$252.50	$252.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $160.97 / $247.92 / $421.93	Professional		$160.97	$247.92	$421.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $226.91	Professional		$32.34	$32.34	$226.91
United Facility/Professional Professional Modifier Low / Median / High Price $198.73 / $253.93 / $374.00	Professional		$198.73	$253.93	$374.00