Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $292.83 / $911.25 / $2,500.00	Facility		$292.83	$911.25	$2,500.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $75.70 / $124.21 / $206.48	Facility	52	$75.70	$124.21	$206.48
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $30.28 / $49.68 / $82.59	Facility	53	$30.28	$49.68	$82.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $126.29 / $248.42 / $472.72	Professional		$126.29	$248.42	$472.72
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $70.01 / $200.36 / $395.35	Professional		$70.01	$200.36	$395.35
BCBS Facility/Professional Facility Modifier Low / Median / High Price $839.58 / $839.58 / $957.12	Facility		$839.58	$839.58	$957.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.53 / $190.48 / $400.01	Professional		$129.53	$190.48	$400.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $112.17 / $154.76 / $190.50	Facility		$112.17	$154.76	$190.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $244.04 / $326.16 / $583.25	Professional		$244.04	$326.16	$583.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $366.00 / $471.20 / $541.88	Facility		$366.00	$471.20	$541.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $151.82 / $269.27 / $479.12	Professional		$151.82	$269.27	$479.12
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $100.61 / $227.32 / $508.35	Professional		$100.61	$227.32	$508.35
United Facility/Professional Facility Modifier Low / Median / High Price $505.00 / $1,106.00 / $2,539.00	Facility		$505.00	$1,106.00	$2,539.00
United Facility/Professional Professional Modifier Low / Median / High Price $254.85 / $345.60 / $525.92	Professional		$254.85	$345.60	$525.92