Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $120.23 / $245.47	Facility		$107.15	$120.23	$245.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.20 / $125.89 / $229.09	Professional		$91.20	$125.89	$229.09
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $102.33 / $134.90 / $208.93	Professional	25	$102.33	$134.90	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $120.23 / $147.91	Professional		$100.00	$120.23	$147.91
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $104.71 / $123.03 / $151.36	Professional	25	$104.71	$123.03	$151.36
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $109.65 / $123.03	Professional		$95.50	$109.65	$123.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $151.36 / $199.53	Facility		$117.49	$151.36	$199.53
CareSource Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $141.25 / $181.97	Professional		$117.49	$141.25	$181.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $204.17 / $204.17	Facility		$204.17	$204.17	$204.17
Cigna Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $117.49 / $616.60	Professional		$117.49	$117.49	$616.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $165.96	Professional		$32.36	$33.11	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $120.23 / $177.83	Professional		$93.33	$120.23	$177.83