Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $370.26 / $1,257.00 / $3,308.00	Facility		$370.26	$1,257.00	$3,308.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $114.17 / $185.14 / $302.18	Facility	52	$114.17	$185.14	$302.18
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $53.01 / $108.62 / $185.46	Facility	53	$53.01	$108.62	$185.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.30 / $347.01 / $572.47	Professional		$192.30	$347.01	$572.47
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $45.67 / $97.54 / $189.65	Professional	53	$45.67	$97.54	$189.65
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $164.89 / $305.39 / $472.72	Professional		$164.89	$305.39	$472.72
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $50.31 / $100.61 / $168.60	Professional	53	$50.31	$100.61	$168.60
BCBS Facility/Professional Facility Modifier Low / Median / High Price $845.19 / $845.19 / $963.52	Facility		$845.19	$845.19	$963.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.53 / $286.07 / $473.72	Professional		$194.53	$286.07	$473.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.47 / $143.65 / $259.36	Facility		$26.47	$143.65	$259.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.28 / $227.99 / $509.87	Professional		$40.28	$227.99	$509.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $458.17 / $515.00 / $584.00	Facility		$458.17	$515.00	$584.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $220.53 / $353.56 / $619.00	Professional		$220.53	$353.56	$619.00
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $320.00 / $320.00 / $320.00	Professional	53	$320.00	$320.00	$320.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $351.21 / $351.21 / $543.63	Professional		$351.21	$351.21	$543.63
Qualchoice Facility/Professional Professional Modifier 53 Low / Median / High Price $57.86 / $115.70 / $193.89	Professional	53	$57.86	$115.70	$193.89
United Facility/Professional Facility Modifier Low / Median / High Price $505.00 / $1,054.00 / $2,539.00	Facility		$505.00	$1,054.00	$2,539.00
United Facility/Professional Professional Modifier Low / Median / High Price $291.80 / $447.24 / $646.66	Professional		$291.80	$447.24	$646.66