Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $489.78 / $1,819.70	Facility		$46.77	$489.78	$1,819.70
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $707.95 / $707.95 / $707.95	Facility	50	$707.95	$707.95	$707.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $57.54 / $138.04	Professional		$33.11	$57.54	$138.04
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $61.66 / $112.20 / $208.93	Professional	50	$61.66	$112.20	$208.93
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $26.92 / $52.48 / $87.10	Professional		$26.92	$52.48	$87.10
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $47.86 / $72.44 / $112.20	Professional	50	$47.86	$72.44	$112.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $380.19	Facility		$275.42	$275.42	$380.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $50.12 / $75.86	Professional		$38.02	$50.12	$75.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $46.77 / $131.83	Facility		$46.77	$46.77	$131.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.04 / $257.04 / $257.04	Facility		$257.04	$257.04	$257.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $63.10 / $85.11	Professional		$39.81	$63.10	$85.11
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $85.11 / $109.65	Professional		$29.51	$85.11	$109.65
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $81.28 / $109.65 / $128.82	Professional	50	$81.28	$109.65	$128.82
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $363.08 / $870.96	Facility		$128.82	$363.08	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $34.67 / $52.48 / $85.11	Professional		$34.67	$52.48	$85.11