Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $47.86	Facility		$47.86	$47.86	$47.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $53.70 / $85.11	Professional		$42.66	$53.70	$85.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $74.13 / $97.72	Professional		$66.07	$74.13	$97.72
BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $100.00 / $123.03	Professional		$61.66	$100.00	$123.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $72.44 / $190.55	Facility		$43.65	$72.44	$190.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $52.48 / $112.20	Professional		$52.48	$52.48	$112.20
Medcost Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $58.88 / $66.07	Professional		$48.98	$58.88	$66.07
Medcost Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $75.86 / $162.18	Facility		$47.86	$75.86	$162.18
Medcost Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $30.90 / $31.62	Professional		$30.90	$30.90	$31.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $66.07	Professional		$30.20	$30.20	$66.07
United Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $63.10 / $131.83	Facility		$47.86	$63.10	$131.83
United Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $48.98 / $66.07	Professional		$38.02	$48.98	$66.07