Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $114.89 / $29,820.88	Facility		$62.10	$114.89	$29,820.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.71 / $72.15	Professional		$62.10	$62.71	$72.15
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $63.39 / $63.39 / $117.69	Professional		$63.39	$63.39	$117.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.58 / $62.10 / $75.38	Facility		$58.58	$62.10	$75.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $62.10	Professional		$62.10	$62.10	$62.10
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $62.10 / $62.10	Facility		$62.10	$62.10	$62.10
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $31.64 / $63.27 / $63.27	Professional		$31.64	$63.27	$63.27
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.57 / $53.43 / $77.72	Professional		$48.57	$53.43	$77.72
United Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $65.83 / $69.13	Professional		$62.10	$65.83	$69.13
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $63.39 / $63.39	Professional		$62.10	$63.39	$63.39