Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $103.25 / $1,064.00 / $2,812.00	Facility		$103.25	$1,064.00	$2,812.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,414.40 / $2,414.40 / $2,414.40	Facility	50	$2,414.40	$2,414.40	$2,414.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.87 / $113.92 / $214.05	Professional		$68.87	$113.92	$214.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $133.05 / $133.05 / $133.05	Professional		$133.05	$133.05	$133.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,525.10 / $1,525.10 / $1,830.12	Facility		$1,525.10	$1,525.10	$1,830.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.89 / $111.61 / $202.35	Professional		$75.89	$111.61	$202.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $120.96 / $120.96 / $120.96	Facility		$120.96	$120.96	$120.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $190.76 / $198.39 / $355.04	Professional		$190.76	$198.39	$355.04
Cigna Facility/Professional Facility Modifier Low / Median / High Price $788.55 / $788.55 / $788.55	Facility		$788.55	$788.55	$788.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $108.65 / $142.00 / $216.85	Professional		$108.65	$142.00	$216.85
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $153.01 / $153.01 / $153.01	Professional		$153.01	$153.01	$153.01
United Facility/Professional Facility Modifier Low / Median / High Price $590.00 / $1,230.00 / $2,539.00	Facility		$590.00	$1,230.00	$2,539.00
United Facility/Professional Professional Modifier Low / Median / High Price $114.51 / $164.82 / $269.89	Professional		$114.51	$164.82	$269.89