Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $210.62 / $1,083.00 / $2,863.13	Facility		$210.62	$1,083.00	$2,863.13
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $147.03 / $164.77 / $182.88	Facility	54	$147.03	$164.77	$182.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.28 / $183.70 / $246.54	Professional		$144.28	$183.70	$246.54
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $282.04 / $302.70 / $302.82	Professional		$282.04	$302.70	$302.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $379.42 / $379.42 / $455.30	Facility		$379.42	$379.42	$455.30
BCBS Facility/Professional Professional Modifier Low / Median / High Price $185.68 / $245.75 / $284.97	Professional		$185.68	$245.75	$284.97
CareSource Facility/Professional Professional Modifier Low / Median / High Price $203.70 / $203.70 / $203.70	Professional		$203.70	$203.70	$203.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $146.88 / $146.88 / $146.88	Facility		$146.88	$146.88	$146.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.16 / $266.32 / $340.16	Professional		$158.16	$266.32	$340.16
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $348.11 / $348.24 / $348.24	Professional		$348.11	$348.24	$348.24
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $328.00 / $858.00	Facility		$130.00	$328.00	$858.00
United Facility/Professional Professional Modifier Low / Median / High Price $164.59 / $215.45 / $356.10	Professional		$164.59	$215.45	$356.10