Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $100.00 / $338.84	Facility		$34.67	$100.00	$338.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $645.65 / $645.65 / $645.65	Facility	50	$645.65	$645.65	$645.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.55 / $51.29 / $114.82	Professional		$24.55	$51.29	$114.82
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $138.04 / $138.04 / $138.04	Professional	50	$138.04	$138.04	$138.04
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $74.13 / $104.71	Professional		$23.99	$74.13	$104.71
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $112.20 / $131.83 / $144.54	Professional	50	$112.20	$131.83	$144.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.91 / $147.91 / $204.17	Facility		$147.91	$147.91	$204.17
BCBS Facility/Professional Professional Modifier Low / Median / High Price $29.51 / $38.90 / $123.03	Professional		$29.51	$38.90	$123.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.67 / $34.67 / $100.00	Facility		$34.67	$34.67	$100.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $100.00	Professional		$100.00	$100.00	$100.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $107.15 / $107.15	Facility		$107.15	$107.15	$107.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $72.44 / $141.25	Professional		$30.20	$72.44	$141.25
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $120.23 / $141.25	Professional		$120.23	$120.23	$141.25
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $331.13 / $776.25	Facility		$128.82	$331.13	$776.25
United Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $74.13 / $138.04	Professional		$25.70	$74.13	$138.04