Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.24 / $624.00 / $2,500.00	Facility		$47.24	$624.00	$2,500.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $700.00 / $700.00 / $700.00	Facility	50	$700.00	$700.00	$700.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.02 / $49.15 / $88.40	Professional		$34.02	$49.15	$88.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $50.27 / $111.53 / $183.60	Professional	50	$50.27	$111.53	$183.60
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $38.21 / $74.22 / $84.90	Professional		$38.21	$74.22	$84.90
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $108.00 / $114.62 / $114.62	Professional	50	$108.00	$114.62	$114.62
BCBS Facility/Professional Facility Modifier Low / Median / High Price $276.52 / $276.52 / $331.84	Facility		$276.52	$276.52	$331.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.15 / $56.12 / $75.59	Professional		$38.15	$56.12	$75.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.19 / $46.30 / $130.69	Facility		$42.19	$46.30	$130.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $60.85 / $60.85 / $63.28	Professional		$60.85	$60.85	$63.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.91 / $257.91 / $257.91	Facility		$257.91	$257.91	$257.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.08 / $66.95 / $85.36	Professional		$45.08	$66.95	$85.36
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $42.68 / $80.33 / $101.98	Professional		$42.68	$80.33	$101.98
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $124.20 / $131.81 / $131.81	Professional	50	$124.20	$131.81	$131.81
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $328.00 / $768.00	Facility		$130.00	$328.00	$768.00
United Facility/Professional Professional Modifier Low / Median / High Price $45.21 / $64.34 / $99.32	Professional		$45.21	$64.34	$99.32