Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $155.54 / $1,064.00 / $2,500.00	Facility		$155.54	$1,064.00	$2,500.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $384.55 / $1,298.75 / $2,805.28	Facility	50	$384.55	$1,298.75	$2,805.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.34 / $175.65 / $274.16	Professional		$101.34	$175.65	$274.16
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $154.08 / $257.31 / $624.71	Professional	50	$154.08	$257.31	$624.71
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $164.97 / $164.97 / $164.97	Professional		$164.97	$164.97	$164.97
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $229.07 / $229.07 / $254.01	Professional	50	$229.07	$229.07	$254.01
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 $118.97 / $174.95 / $285.08	Professional		$118.97	$174.95	$285.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.79 / $135.91 / $383.57	Facility		$123.79	$135.91	$383.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $213.55 / $213.55 / $222.09	Professional		$213.55	$213.55	$222.09
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 $148.52 / $237.64 / $388.49	Professional		$148.52	$237.64	$388.49
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $263.43 / $263.43 / $263.43	Professional	50	$263.43	$263.43	$263.43
United Facility/Professional Facility Modifier Low / Median / High Price $330.00 / $811.00 / $1,574.00	Facility		$330.00	$811.00	$1,574.00
United Facility/Professional Professional Modifier Low / Median / High Price $174.06 / $270.04 / $439.93	Professional		$174.06	$270.04	$439.93