Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $359.67 / $1,083.00 / $3,695.39	Facility		$359.67	$1,083.00	$3,695.39
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $124.29 / $236.10 / $388.84	Facility	52	$124.29	$236.10	$388.84
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $49.72 / $81.29 / $129.83	Facility	53	$49.72	$81.29	$129.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $217.81 / $406.46 / $845.37	Professional		$217.81	$406.46	$845.37
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $106.06 / $203.23 / $321.61	Professional	52	$106.06	$203.23	$321.61
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $42.42 / $74.00 / $106.84	Professional	53	$42.42	$74.00	$106.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $233.17 / $332.23 / $410.91	Professional		$233.17	$332.23	$410.91
Ambetter Facility/Professional Professional Modifier 52 Low / Median / High Price $71.56 / $71.56 / $71.56	Professional	52	$71.56	$71.56	$71.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,101.34 / $1,101.34 / $1,255.54	Facility		$1,101.34	$1,101.34	$1,255.54
BCBS Facility/Professional Professional Modifier Low / Median / High Price $211.60 / $311.17 / $603.07	Professional		$211.60	$311.17	$603.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $183.78 / $253.44 / $311.26	Facility		$183.78	$253.44	$311.26
CareSource Facility/Professional Professional Modifier Low / Median / High Price $367.55 / $491.91 / $882.24	Professional		$367.55	$491.91	$882.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $490.00 / $565.00 / $681.35	Facility		$490.00	$565.00	$681.35
Cigna Facility/Professional Professional Modifier Low / Median / High Price $240.76 / $411.66 / $731.61	Professional		$240.76	$411.66	$731.61
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $362.66 / $440.35 / $728.62	Professional		$362.66	$440.35	$728.62
Qualchoice Facility/Professional Professional Modifier 52 Low / Median / High Price $82.31 / $82.31 / $82.31	Professional	52	$82.31	$82.31	$82.31
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 $380.86 / $529.86 / $796.88	Professional		$380.86	$529.86	$796.88