Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.33 / $803.00 / $2,812.00	Facility		$51.33	$803.00	$2,812.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.95 / $54.72 / $80.81	Professional		$36.95	$54.72	$80.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $84.59 / $92.12 / $106.91	Professional		$84.59	$92.12	$106.91
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 $43.70 / $64.26 / $91.13	Professional		$43.70	$64.26	$91.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.31 / $53.31 / $152.22	Facility		$53.31	$53.31	$152.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $73.48 / $73.48 / $76.43	Professional		$73.48	$73.48	$76.43
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 $53.86 / $74.94 / $103.61	Professional		$53.86	$74.94	$103.61
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $97.28 / $105.94 / $122.95	Professional		$97.28	$105.94	$122.95
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 $53.99 / $70.40 / $119.56	Professional		$53.99	$70.40	$119.56