Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $372.64 / $1,342.00 / $3,109.00	Facility		$372.64	$1,342.00	$3,109.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $403.00 / $403.00 / $2,617.94	Facility	50	$403.00	$403.00	$2,617.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $297.81 / $1,201.31 / $2,613.89	Professional		$297.81	$1,201.31	$2,613.89
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $4,962.30 / $4,962.30 / $4,962.30	Professional	50	$4,962.30	$4,962.30	$4,962.30
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $227.32 / $1,851.26 / $2,008.27	Professional		$227.32	$1,851.26	$2,008.27
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $364.76 / $628.63 / $729.52	Professional	50	$364.76	$628.63	$729.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $291.50 / $428.67 / $1,810.76	Professional		$291.50	$428.67	$1,810.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $277.95 / $367.56 / $404.57	Facility		$277.95	$367.56	$404.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,142.75 / $1,349.87 / $1,655.06	Professional		$1,142.75	$1,349.87	$1,655.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $346.65 / $597.33 / $2,714.34	Professional		$346.65	$597.33	$2,714.34
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $261.42 / $2,128.94 / $2,309.51	Professional		$261.42	$2,128.94	$2,309.51
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $419.47 / $419.47 / $502.04	Professional	50	$419.47	$419.47	$502.04
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $345.00 / $768.00	Facility		$130.00	$345.00	$768.00
United Facility/Professional Professional Modifier Low / Median / High Price $577.03 / $2,113.76 / $2,918.69	Professional		$577.03	$2,113.76	$2,918.69