Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $342.25 / $1,262.00 / $3,109.00	Facility		$342.25	$1,262.00	$3,109.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $66.66 / $108.64 / $265.83	Facility	52	$66.66	$108.64	$265.83
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $26.66 / $43.46 / $106.33	Facility	53	$26.66	$43.46	$106.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.14 / $217.28 / $476.83	Professional		$97.14	$217.28	$476.83
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $115.82 / $227.10 / $461.06	Professional		$115.82	$227.10	$461.06
BCBS Facility/Professional Facility Modifier Low / Median / High Price $839.58 / $839.58 / $957.12	Facility		$839.58	$839.58	$957.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.42 / $165.33 / $403.84	Professional		$112.42	$165.33	$403.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.55 / $134.15 / $164.21	Facility		$97.55	$134.15	$164.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $245.24 / $326.69 / $581.79	Professional		$245.24	$326.69	$581.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $471.20 / $515.00 / $561.00	Facility		$471.20	$515.00	$561.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $127.48 / $211.49 / $509.65	Professional		$127.48	$211.49	$509.65
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $133.19 / $204.25 / $530.22	Professional		$133.19	$204.25	$530.22
United Facility/Professional Facility Modifier Low / Median / High Price $505.00 / $1,106.00 / $2,539.00	Facility		$505.00	$1,106.00	$2,539.00
United Facility/Professional Professional Modifier Low / Median / High Price $268.77 / $372.25 / $582.19	Professional		$268.77	$372.25	$582.19