Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $140.78 / $849.06 / $2,493.00	Facility		$140.78	$849.06	$2,493.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $943.00 / $1,298.06 / $6,378.64	Facility	50	$943.00	$1,298.06	$6,378.64
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $27.21 / $49.74 / $93.33	Facility	53	$27.21	$49.74	$93.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $95.09 / $219.71 / $401.72	Professional		$95.09	$219.71	$401.72
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $275.82 / $731.81 / $854.25	Professional	50	$275.82	$731.81	$854.25
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $21.40 / $36.58 / $66.89	Professional	53	$21.40	$36.58	$66.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $161.13 / $161.13 / $361.84	Professional		$161.13	$161.13	$361.84
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $241.71 / $257.19 / $542.75	Professional	50	$241.71	$257.19	$542.75
BCBS Facility/Professional Facility Modifier Low / Median / High Price $866.69 / $866.69 / $1,040.03	Facility		$866.69	$866.69	$1,040.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.83 / $185.05 / $363.52	Professional		$125.83	$185.05	$363.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $130.29 / $143.09 / $403.62	Facility		$130.29	$143.09	$403.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $268.54 / $268.54 / $279.27	Professional		$268.54	$268.54	$279.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $726.58 / $726.58 / $726.58	Facility		$726.58	$726.58	$726.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $145.27 / $244.14 / $457.80	Professional		$145.27	$244.14	$457.80
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $185.31 / $185.31 / $416.12	Professional		$185.31	$185.31	$416.12
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $277.97 / $295.77 / $624.16	Professional	50	$277.97	$295.77	$624.16
United Facility/Professional Facility Modifier Low / Median / High Price $330.00 / $765.00 / $1,574.00	Facility		$330.00	$765.00	$1,574.00
United Facility/Professional Professional Modifier Low / Median / High Price $208.36 / $295.61 / $479.11	Professional		$208.36	$295.61	$479.11