Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $86.72 / $572.00 / $2,812.00	Facility		$86.72	$572.00	$2,812.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.92 / $99.76 / $160.86	Professional		$56.92	$99.76	$160.86
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.15 / $112.15 / $146.60	Professional		$112.15	$112.15	$146.60
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $168.22 / $168.22 / $168.22	Professional	50	$168.22	$168.22	$168.22
BCBS Facility/Professional Facility Modifier Low / Median / High Price $276.52 / $276.52 / $331.84	Facility		$276.52	$276.52	$331.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.37 / $82.90 / $164.67	Professional		$56.37	$82.90	$164.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.56 / $66.88 / $264.88	Facility		$61.56	$66.88	$264.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $123.54 / $123.54 / $128.47	Professional		$123.54	$123.54	$128.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $257.91 / $257.91 / $257.91	Facility		$257.91	$257.91	$257.91
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.66 / $137.13 / $241.41	Professional		$74.66	$137.13	$241.41
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $168.59 / $168.59 / $168.59	Professional		$168.59	$168.59	$168.59
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $345.00 / $768.00	Facility		$130.00	$345.00	$768.00
United Facility/Professional Professional Modifier Low / Median / High Price $96.17 / $145.72 / $209.44	Professional		$96.17	$145.72	$209.44