Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $242.19 / $803.00 / $2,812.00	Facility		$242.19	$803.00	$2,812.00
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $166.91 / $183.71 / $226.34	Facility	54	$166.91	$183.71	$226.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $175.61 / $217.29 / $338.76	Professional		$175.61	$217.29	$338.76
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $136.56 / $176.88 / $214.95	Professional	54	$136.56	$176.88	$214.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $198.50 / $240.18 / $316.77	Professional		$198.50	$240.18	$316.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $210.54 / $210.54 / $252.65	Facility		$210.54	$210.54	$252.65
BCBS Facility/Professional Professional Modifier Low / Median / High Price $223.34 / $295.60 / $313.83	Professional		$223.34	$295.60	$313.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $245.54 / $267.13 / $737.17	Facility		$245.54	$267.13	$737.17
CareSource Facility/Professional Professional Modifier Low / Median / High Price $251.99 / $251.99 / $262.07	Professional		$251.99	$251.99	$262.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.26 / $167.26 / $167.26	Facility		$167.26	$167.26	$167.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.15 / $314.01 / $383.13	Professional		$199.15	$314.01	$383.13
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $276.20 / $364.29 / $364.29	Professional		$276.20	$364.29	$364.29
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 $197.84 / $282.63 / $402.03	Professional		$197.84	$282.63	$402.03