Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $622.23 / $2,008.00 / $4,787.00	Facility		$622.23	$2,008.00	$4,787.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $4,867.50 / $7,034.85 / $9,755.00	Facility	50	$4,867.50	$7,034.85	$9,755.00
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,080.95 / $2,967.90 / $7,111.95	Professional	50	$1,080.95	$2,967.90	$7,111.95
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $529.98 / $1,059.95 / $4,751.51	Professional	50	$529.98	$1,059.95	$4,751.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,227.30 / $5,227.30 / $6,272.76	Facility		$5,227.30	$5,227.30	$6,272.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $345.47 / $459.41 / $492.50	Facility		$345.47	$459.41	$492.50
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $609.48 / $1,218.94 / $5,464.24	Professional	50	$609.48	$1,218.94	$5,464.24
United Facility/Professional Facility Modifier Low / Median / High Price $2,104.00 / $4,555.00 / $8,676.00	Facility		$2,104.00	$4,555.00	$8,676.00