Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.20 / $624.00 / $2,500.00	Facility		$87.20	$624.00	$2,500.00
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $12.98 / $22.10 / $41.90	Facility	53	$12.98	$22.10	$41.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.18 / $96.65 / $154.49	Professional		$48.18	$96.65	$154.49
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $130.49 / $130.49 / $148.71	Professional	50	$130.49	$130.49	$148.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $73.95 / $79.89 / $163.57	Professional		$73.95	$79.89	$163.57
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $110.93 / $110.93 / $122.87	Professional	50	$110.93	$110.93	$122.87
BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.24 / $85.65 / $164.25	Professional		$58.24	$85.65	$164.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.61 / $65.67 / $150.94	Facility		$59.61	$65.67	$150.94
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.40 / $121.40 / $126.26	Professional		$121.40	$121.40	$126.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $375.59 / $375.59 / $375.59	Facility		$375.59	$375.59	$375.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.34 / $116.85 / $222.07	Professional		$75.34	$116.85	$222.07
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $85.04 / $85.04 / $188.11	Professional		$85.04	$85.04	$188.11
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $330.00 / $768.00	Facility		$130.00	$330.00	$768.00
United Facility/Professional Professional Modifier Low / Median / High Price $92.94 / $145.66 / $244.96	Professional		$92.94	$145.66	$244.96