Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $346.74 / $501.19	Facility		$208.93	$346.74	$501.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $245.47	Professional		$208.93	$208.93	$245.47
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $177.83 / $208.93 / $208.93	Professional		$177.83	$208.93	$208.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $208.93 / $239.88	Facility		$199.53	$208.93	$239.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Facility		$208.93	$208.93	$208.93
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $223.87 / $223.87	Professional		$112.20	$223.87	$223.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $218.78 / $245.47 / $389.05	Professional		$218.78	$245.47	$389.05
United Facility/Professional Facility Modifier Low / Median / High Price $204.17 / $208.93 / $363.08	Facility		$204.17	$208.93	$363.08
United Facility/Professional Professional Modifier Low / Median / High Price $204.17 / $223.87 / $234.42	Professional		$204.17	$223.87	$234.42
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $208.93 / $208.93	Professional		$208.93	$208.93	$208.93