Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.50 / $1,226.88 / $2,493.00	Facility		$180.50	$1,226.88	$2,493.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $480.50 / $480.50 / $943.00	Facility	50	$480.50	$480.50	$943.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.07 / $180.50 / $288.80	Professional		$123.07	$180.50	$288.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $146.24 / $219.36 / $268.04	Professional		$146.24	$219.36	$268.04
BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.51 / $178.03 / $178.03	Professional		$134.51	$178.03	$178.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $202.13 / $202.13 / $202.13	Facility		$202.13	$202.13	$202.13
CareSource Facility/Professional Professional Modifier Low / Median / High Price $159.04 / $165.40 / $312.44	Professional		$159.04	$165.40	$312.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $190.65 / $230.53 / $260.67	Professional		$190.65	$230.53	$260.67
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $168.18 / $252.26 / $308.25	Professional		$168.18	$252.26	$308.25
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $337.00 / $858.00	Facility		$130.00	$337.00	$858.00
United Facility/Professional Professional Modifier Low / Median / High Price $130.34 / $181.16 / $280.04	Professional		$130.34	$181.16	$280.04