Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.08 / $1,000.00 / $2,812.00	Facility		$140.08	$1,000.00	$2,812.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $328.25 / $3,830.13 / $3,830.13	Facility	50	$328.25	$3,830.13	$3,830.13
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $157.58 / $687.23 / $942.40	Professional	50	$157.58	$687.23	$942.40
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $347.36 / $347.36 / $347.36	Professional	50	$347.36	$347.36	$347.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $113.21 / $150.47 / $161.25	Facility		$113.21	$150.47	$161.25
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $399.46 / $399.46 / $399.46	Professional	50	$399.46	$399.46	$399.46
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $337.00 / $768.00	Facility		$130.00	$337.00	$768.00