Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $310.27 / $1,074.00 / $4,765.60	Facility		$310.27	$1,074.00	$4,765.60
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $94.62 / $120.33 / $580.90	Facility	52	$94.62	$120.33	$580.90
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $37.85 / $48.13 / $232.36	Facility	53	$37.85	$48.13	$232.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $154.38 / $235.59 / $1,255.80	Professional		$154.38	$235.59	$1,255.80
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $120.06 / $245.78 / $263.75	Professional		$120.06	$245.78	$263.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,771.26 / $1,771.26 / $2,019.24	Facility		$1,771.26	$1,771.26	$2,019.24
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.00 / $238.24 / $1,469.99	Professional		$162.00	$238.24	$1,469.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $140.09 / $193.20 / $237.49	Facility		$140.09	$193.20	$237.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $860.67 / $1,144.65 / $2,020.43	Professional		$860.67	$1,144.65	$2,020.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $490.00 / $515.00 / $930.22	Facility		$490.00	$515.00	$930.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.99 / $289.66 / $1,784.59	Professional		$182.99	$289.66	$1,784.59
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $150.16 / $282.64 / $321.13	Professional		$150.16	$282.64	$321.13
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 $173.57 / $1,069.63 / $1,960.70	Professional		$173.57	$1,069.63	$1,960.70