Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.04 / $803.00 / $2,812.00	Facility		$40.04	$803.00	$2,812.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $17.53 / $22.67 / $59.16	Facility	52	$17.53	$22.67	$59.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.74 / $56.44 / $90.13	Professional		$30.74	$56.44	$90.13
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.37 / $28.22 / $41.11	Professional	52	$15.37	$28.22	$41.11
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $47.28 / $47.28	Professional		$36.11	$47.28	$47.28
BCBS Facility/Professional Facility Modifier Low / Median / High Price $118.09 / $118.09 / $141.71	Facility		$118.09	$118.09	$141.71
BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.44 / $37.40 / $81.93	Professional		$25.44	$37.40	$81.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.45 / $35.45 / $35.45	Facility		$35.45	$35.45	$35.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $68.16 / $70.89 / $126.54	Professional		$68.16	$70.89	$126.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.53 / $67.53 / $67.53	Facility		$67.53	$67.53	$67.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.19 / $67.59 / $112.63	Professional		$41.19	$67.59	$112.63
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $54.37 / $54.37 / $54.37	Professional		$54.37	$54.37	$54.37
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $337.00 / $858.00	Facility		$130.00	$337.00	$858.00
United Facility/Professional Professional Modifier Low / Median / High Price $55.75 / $79.03 / $125.99	Professional		$55.75	$79.03	$125.99