Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $58.88 / $58.88	Facility		$58.88	$58.88	$58.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $66.07 / $109.65	Professional		$56.23	$66.07	$109.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $199.53 / $199.53	Professional		$199.53	$199.53	$199.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $134.90 / $169.82	Professional		$112.20	$134.90	$169.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $28.18 / $104.71 / $208.93	Facility		$28.18	$104.71	$208.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $89.13 / $151.36	Professional		$89.13	$89.13	$151.36
Medcost Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $77.62 / $85.11	Professional		$66.07	$77.62	$85.11
Medcost Facility/Professional Facility Modifier Low / Median / High Price $58.88 / $97.72 / $208.93	Facility		$58.88	$97.72	$208.93
Medcost Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $38.02 / $38.02	Professional		$38.02	$38.02	$38.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Professional		$30.20	$30.20	$30.20
United Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $89.13 / $158.49	Facility		$77.62	$89.13	$158.49
United Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $66.07 / $91.20	Professional		$48.98	$66.07	$91.20