Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.03 / $138.81 / $6,838.73	Facility		$75.03	$138.81	$6,838.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $75.78 / $91.42	Professional		$75.03	$75.78	$91.42
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $75.03 / $75.03	Professional		$75.03	$75.03	$75.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.78 / $75.02 / $96.31	Facility		$70.78	$75.02	$96.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.02 / $75.02 / $75.02	Professional		$75.02	$75.02	$75.02
Florida Blue Facility/Professional Facility Modifier Low / Median / High Price $57.31 / $75.03 / $75.03	Facility		$57.31	$75.03	$75.03
Florida Blue Facility/Professional Professional Modifier Low / Median / High Price $37.52 / $75.03 / $75.03	Professional		$37.52	$75.03	$75.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $12.08 / $13.29 / $20.54	Professional		$12.08	$13.29	$20.54
United Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $79.53 / $83.52	Professional		$75.03	$79.53	$83.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $75.03 / $76.18 / $76.18	Professional		$75.03	$76.18	$76.18