Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $228.52 / $228.52 / $228.52	Facility	25	$228.52	$228.52	$228.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.87 / $124.62 / $227.59	Professional		$91.87	$124.62	$227.59
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $97.93 / $123.52 / $205.99	Professional	25	$97.93	$123.52	$205.99
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.47 / $168.66 / $183.30	Professional		$120.47	$168.66	$183.30
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $119.96 / $143.94 / $195.42	Professional	25	$119.96	$143.94	$195.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $91.51 / $138.07	Professional		$55.00	$91.51	$138.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $146.59 / $146.59 / $146.59	Facility		$146.59	$146.59	$146.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $116.36 / $136.00	Professional		$116.36	$116.36	$136.00
Medcost Facility/Professional Facility Modifier Low / Median / High Price $104.18 / $127.20 / $209.98	Facility		$104.18	$127.20	$209.98
Medcost Facility/Professional Professional Modifier Low / Median / High Price $104.18 / $104.18 / $155.93	Professional		$104.18	$104.18	$155.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $109.81 / $149.51 / $235.77	Professional		$109.81	$149.51	$235.77
United Facility/Professional Professional Modifier Low / Median / High Price $93.76 / $112.71 / $202.22	Professional		$93.76	$112.71	$202.22