Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.88 / $75.86 / $169.82	Professional		$58.88	$75.86	$169.82
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $58.88 / $79.43 / $186.21	Professional	25	$58.88	$79.43	$186.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $77.62 / $117.49	Professional		$64.57	$77.62	$117.49
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $58.88 / $70.79 / $131.83	Professional	25	$58.88	$70.79	$131.83
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 $69.18 / $100.00 / $190.55	Professional		$69.18	$100.00	$190.55
Medcost Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $83.18 / $147.91	Facility		$63.10	$83.18	$147.91
Medcost Facility/Professional Professional Modifier Low / Median / High Price $467.74 / $467.74 / $467.74	Professional		$467.74	$467.74	$467.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $181.97	Professional		$32.36	$33.11	$181.97
United Facility/Professional Facility Modifier Low / Median / High Price $489.78 / $489.78 / $645.65	Facility		$489.78	$489.78	$645.65
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $85.11 / $125.89	Professional		$67.61	$85.11	$125.89