Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.42 / $73.42 / $73.73	Facility		$73.42	$73.42	$73.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.35 / $71.75 / $110.03	Professional		$57.35	$71.75	$110.03
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $124.22 / $124.22 / $245.55	Professional	25	$124.22	$124.22	$245.55
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.75 / $70.75 / $71.06	Professional		$70.75	$70.75	$71.06
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $57.25 / $57.25 / $131.66	Professional	25	$57.25	$57.25	$131.66
BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.20 / $77.01 / $77.01	Facility		$76.20	$77.01	$77.01
BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.34 / $80.09 / $96.26	Professional		$70.34	$80.09	$96.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.69 / $87.75 / $283.14	Professional		$57.69	$87.75	$283.14
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $71.06 / $71.39 / $73.73	Facility		$71.06	$71.39	$73.73
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $63.35 / $73.42 / $120.81	Professional		$63.35	$73.42	$120.81
Health Alliance Plan Facility/Professional Professional Modifier 25 Low / Median / High Price $124.22 / $124.22 / $124.22	Professional	25	$124.22	$124.22	$124.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $67.86 / $96.25	Professional		$54.60	$67.86	$96.25
United Facility/Professional Professional Modifier Low / Median / High Price $68.97 / $83.77 / $103.46	Professional		$68.97	$83.77	$103.46
United Facility/Professional Professional Modifier 25 Low / Median / High Price $94.07 / $94.07 / $94.07	Professional	25	$94.07	$94.07	$94.07