Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.87 / $624.59 / $1,821.00	Facility		$71.87	$624.59	$1,821.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $476.78 / $626.99 / $790.92	Facility	50	$476.78	$626.99	$790.92
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $28.13 / $35.94 / $46.14	Facility	52	$28.13	$35.94	$46.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.48 / $66.64 / $128.61	Professional		$45.48	$66.64	$128.61
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $75.06 / $150.22 / $352.00	Professional	50	$75.06	$150.22	$352.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $58.57 / $88.49 / $99.26	Professional		$58.57	$88.49	$99.26
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $97.13 / $140.90 / $157.66	Professional	50	$97.13	$140.90	$157.66
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 $48.11 / $68.79 / $91.04	Professional		$48.11	$68.79	$91.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.58 / $58.62 / $167.69	Facility		$53.58	$58.62	$167.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.63 / $73.63 / $76.56	Professional		$73.63	$73.63	$76.56
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 $56.38 / $84.74 / $115.71	Professional		$56.38	$84.74	$115.71
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $74.45 / $105.56 / $117.29	Professional		$74.45	$105.56	$117.29
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $111.70 / $162.18 / $183.76	Professional	50	$111.70	$162.18	$183.76
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 $55.58 / $83.04 / $123.39	Professional		$55.58	$83.04	$123.39
United Facility/Professional Professional Modifier 50 Low / Median / High Price $136.40 / $136.40 / $136.40	Professional	50	$136.40	$136.40	$136.40