Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $302.00 / $1,230.27 / $2,570.40	Facility		$302.00	$1,230.27	$2,570.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $1,071.52 / $1,071.52 / $1,071.52	Facility	52	$1,071.52	$1,071.52	$1,071.52
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $75.86 / $162.18 / $199.53	Facility	53	$75.86	$162.18	$199.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $316.23 / $691.83	Professional		$173.78	$316.23	$691.83
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $83.18 / $141.25 / $229.09	Professional	53	$83.18	$141.25	$229.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $154.88 / $208.93 / $363.08	Professional		$154.88	$208.93	$363.08
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $46.77 / $81.28 / $131.83	Professional	53	$46.77	$81.28	$131.83
BCBS Facility/Professional Facility Modifier Low / Median / High Price $851.14 / $851.14 / $1,148.15	Facility		$851.14	$851.14	$1,148.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.98 / $257.04 / $478.63	Professional		$194.98	$257.04	$478.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.92 / $165.96 / $251.19	Facility		$26.92	$165.96	$251.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $93.33 / $724.44	Professional		$40.74	$93.33	$724.44
Cigna Facility/Professional Facility Modifier Low / Median / High Price $457.09 / $512.86 / $912.01	Facility		$457.09	$512.86	$912.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $199.53 / $331.13 / $562.34	Professional		$199.53	$331.13	$562.34
Cigna Facility/Professional Professional Modifier 53 Low / Median / High Price $323.59 / $323.59 / $323.59	Professional	53	$323.59	$323.59	$323.59
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $302.00 / $371.54 / $549.54	Professional		$302.00	$371.54	$549.54
Qualchoice Facility/Professional Professional Modifier 53 Low / Median / High Price $77.62 / $114.82 / $154.88	Professional	53	$77.62	$114.82	$154.88
United Facility/Professional Facility Modifier Low / Median / High Price $537.03 / $1,096.48 / $2,630.27	Facility		$537.03	$1,096.48	$2,630.27
United Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $323.59 / $549.54	Professional		$181.97	$323.59	$549.54
United Facility/Professional Professional Modifier 53 Low / Median / High Price $218.78 / $218.78 / $218.78	Professional	53	$218.78	$218.78	$218.78