Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $386.49 / $386.49 / $595.10	Professional		$386.49	$386.49	$595.10
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $116.38 / $178.05 / $469.99	Professional		$116.38	$178.05	$469.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.79 / $137.16 / $155.08	Facility		$104.79	$137.16	$155.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $99.47 / $116.84 / $143.26	Professional		$99.47	$116.84	$143.26
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $133.84 / $143.72 / $204.76	Professional		$133.84	$143.72	$204.76
United Facility/Professional Professional Modifier Low / Median / High Price $326.57 / $432.17 / $674.30	Professional		$326.57	$432.17	$674.30