Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.13 / $123.13 / $123.13	Facility		$123.13	$123.13	$123.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.15 / $132.49 / $200.22	Professional		$105.15	$132.49	$200.22
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $170.76 / $261.39 / $261.39	Professional	25	$170.76	$261.39	$261.39
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.57 / $154.57 / $165.39	Professional		$154.57	$154.57	$165.39
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $156.49 / $156.49 / $156.49	Professional	25	$156.49	$156.49	$156.49
BCBS Facility/Professional Professional Modifier Low / Median / High Price $92.37 / $123.01 / $196.56	Professional		$92.37	$123.01	$196.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $174.07 / $174.07 / $174.07	Facility		$174.07	$174.07	$174.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $147.90 / $147.90	Professional		$147.90	$147.90	$147.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $32.34	Professional		$32.34	$32.34	$32.34
Providence Facility/Professional Facility Modifier Low / Median / High Price $91.91 / $150.97 / $197.15	Facility		$91.91	$150.97	$197.15
Providence Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $275.81 / $428.04	Professional		$147.90	$275.81	$428.04
United Facility/Professional Professional Modifier Low / Median / High Price $125.93 / $215.26 / $328.65	Professional		$125.93	$215.26	$328.65