Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $594.61 / $1,342.00 / $3,804.00	Facility		$594.61	$1,342.00	$3,804.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $206.47 / $206.47 / $335.93	Facility	52	$206.47	$206.47	$335.93
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $82.59 / $82.59 / $134.37	Facility	53	$82.59	$82.59	$134.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $329.41 / $472.50 / $638.40	Professional		$329.41	$472.50	$638.40
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $549.16 / $549.16 / $549.16	Professional		$549.16	$549.16	$549.16
BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,613.23 / $2,613.23 / $2,979.08	Facility		$2,613.23	$2,613.23	$2,979.08
BCBS Facility/Professional Professional Modifier Low / Median / High Price $350.81 / $464.31 / $515.90	Professional		$350.81	$464.31	$515.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $302.86 / $417.11 / $511.42	Facility		$302.86	$417.11	$511.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $292.11 / $393.72 / $721.13	Professional		$292.11	$393.72	$721.13
Cigna Facility/Professional Facility Modifier Low / Median / High Price $515.00 / $561.00 / $1,504.86	Facility		$515.00	$561.00	$1,504.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $316.72 / $528.02 / $674.13	Professional		$316.72	$528.02	$674.13
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $631.54 / $631.54 / $631.54	Professional		$631.54	$631.54	$631.54
United Facility/Professional Facility Modifier Low / Median / High Price $505.00 / $1,106.00 / $2,558.00	Facility		$505.00	$1,106.00	$2,558.00
United Facility/Professional Professional Modifier Low / Median / High Price $307.14 / $415.32 / $688.28	Professional		$307.14	$415.32	$688.28