Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $97.72 / $128.82 / $245.47	Facility		$97.72	$128.82	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $151.36 / $257.04	Professional		$100.00	$151.36	$257.04
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $104.71 / $218.78 / $389.05	Professional	25	$104.71	$218.78	$389.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $154.88 / $302.00	Professional		$131.83	$154.88	$302.00
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $131.83 / $151.36 / $158.49	Professional	25	$131.83	$151.36	$158.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $199.53 / $489.78	Facility		$199.53	$199.53	$489.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $147.91 / $147.91	Professional		$147.91	$147.91	$147.91
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $125.89 / $199.53	Professional		$67.61	$125.89	$199.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $36.31	Professional		$32.36	$33.11	$36.31
United Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $117.49 / $162.18	Facility		$57.54	$117.49	$162.18
United Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $141.25 / $251.19	Professional		$95.50	$141.25	$251.19
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $138.04 / $173.78	Professional		$107.15	$138.04	$173.78