Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $133.52 / $295.81 / $2,500.00	Facility		$133.52	$295.81	$2,500.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $117.35 / $160.30 / $250.14	Professional		$117.35	$160.30	$250.14
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $198.47 / $198.47 / $198.47	Professional		$198.47	$198.47	$198.47
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.09 / $118.09 / $141.71	Facility		$118.09	$118.09	$141.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.11 / $164.87 / $251.32	Professional		$112.11	$164.87	$251.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.53 / $67.53 / $67.53	Facility		$67.53	$67.53	$67.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $109.71 / $197.53 / $335.65	Professional		$109.71	$197.53	$335.65
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $228.24 / $228.24 / $228.24	Professional		$228.24	$228.24	$228.24
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 $161.46 / $200.73 / $368.19	Professional		$161.46	$200.73	$368.19