Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.33 / $107.15 / $138.04	Facility		$102.33	$107.15	$138.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $74.13 / $177.83	Professional		$58.88	$74.13	$177.83
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $66.07 / $83.18 / $263.03	Professional	25	$66.07	$83.18	$263.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $72.44 / $85.11	Professional		$60.26	$72.44	$85.11
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $60.26 / $70.79 / $83.18	Professional	25	$60.26	$70.79	$83.18
BCBS Facility/Professional Facility Modifier Low / Median / High Price $169.82 / $288.40 / $478.63	Facility		$169.82	$288.40	$478.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $77.62 / $102.33	Professional		$61.66	$77.62	$102.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $114.82 / $114.82 / $114.82	Facility		$114.82	$114.82	$114.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $177.83	Professional		$72.44	$100.00	$177.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $117.49	Professional		$32.36	$33.11	$117.49
Providence Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $85.11 / $151.36	Facility		$63.10	$85.11	$151.36
Providence Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $109.65 / $204.17	Professional		$72.44	$109.65	$204.17
United Facility/Professional Facility Modifier Low / Median / High Price $446.68 / $446.68 / $446.68	Facility		$446.68	$446.68	$446.68
United Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $117.49 / $165.96	Professional		$77.62	$117.49	$165.96