Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $306.32 / $989.00 / $2,500.00	Facility		$306.32	$989.00	$2,500.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $124.29 / $203.23 / $315.69	Facility	52	$124.29	$203.23	$315.69
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $49.72 / $81.29 / $126.28	Facility	53	$49.72	$81.29	$126.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $212.88 / $404.66 / $638.62	Professional		$212.88	$404.66	$638.62
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $128.46 / $128.46 / $143.13	Professional		$128.46	$128.46	$143.13
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 / $614.92	Professional		$211.60	$311.17	$614.92
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 $374.50 / $501.12 / $898.39	Professional		$374.50	$501.12	$898.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $490.00 / $515.00 / $918.80	Facility		$490.00	$515.00	$918.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $237.77 / $389.82 / $726.37	Professional		$237.77	$389.82	$726.37
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $147.72 / $164.61 / $164.61	Professional		$147.72	$164.61	$164.61
United Facility/Professional Facility Modifier Low / Median / High Price $529.95 / $1,224.00 / $2,421.00	Facility		$529.95	$1,224.00	$2,421.00
United Facility/Professional Professional Modifier Low / Median / High Price $374.50 / $521.41 / $822.90	Professional		$374.50	$521.41	$822.90