Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $185.09 / $1,064.00 / $2,500.00	Facility		$185.09	$1,064.00	$2,500.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $24.68 / $44.45 / $92.05	Facility	53	$24.68	$44.45	$92.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $94.12 / $224.93 / $378.27	Professional		$94.12	$224.93	$378.27
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $144.00 / $203.23 / $376.69	Professional		$144.00	$203.23	$376.69
BCBS Facility/Professional Facility Modifier Low / Median / High Price $655.30 / $655.30 / $786.37	Facility		$655.30	$655.30	$786.37
BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.34 / $165.20 / $379.84	Professional		$112.34	$165.20	$379.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $116.71 / $128.25 / $359.66	Facility		$116.71	$128.25	$359.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $279.76 / $279.76 / $290.95	Professional		$279.76	$279.76	$290.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $138.13 / $223.37 / $504.58	Professional		$138.13	$223.37	$504.58
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $165.60 / $407.11 / $433.19	Professional		$165.60	$407.11	$433.19
United Facility/Professional Facility Modifier Low / Median / High Price $330.00 / $811.00 / $2,285.00	Facility		$330.00	$811.00	$2,285.00
United Facility/Professional Professional Modifier Low / Median / High Price $223.63 / $323.58 / $496.16	Professional		$223.63	$323.58	$496.16