Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $106.11 / $975.00 / $2,812.00	Facility		$106.11	$975.00	$2,812.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $50.56 / $62.04 / $75.26	Facility	52	$50.56	$62.04	$75.26
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $20.22 / $24.82 / $30.11	Facility	53	$20.22	$24.82	$30.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.15 / $111.49 / $159.18	Professional		$77.15	$111.49	$159.18
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $38.19 / $53.26 / $70.69	Professional	52	$38.19	$53.26	$70.69
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $15.27 / $21.22 / $26.84	Professional	53	$15.27	$21.22	$26.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.76 / $139.76 / $163.56	Professional		$139.76	$139.76	$163.56
BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.16 / $181.16 / $217.39	Facility		$181.16	$181.16	$217.39
BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.29 / $93.08 / $134.19	Professional		$63.29	$93.08	$134.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.73 / $91.73 / $91.73	Facility		$91.73	$91.73	$91.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.04 / $117.56 / $214.19	Professional		$113.04	$117.56	$214.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $154.16 / $154.16 / $154.16	Facility		$154.16	$154.16	$154.16
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.00 / $146.84 / $180.68	Professional		$88.00	$146.84	$180.68
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $188.09 / $188.09 / $188.09	Professional		$188.09	$188.09	$188.09
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $328.00 / $768.00	Facility		$130.00	$328.00	$768.00
United Facility/Professional Professional Modifier Low / Median / High Price $86.11 / $117.16 / $190.75	Professional		$86.11	$117.16	$190.75