Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.83 / $1,071.52 / $2,041.74	Facility		$131.83	$1,071.52	$2,041.74
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $380.19 / $1,288.25 / $2,818.38	Facility	50	$380.19	$1,288.25	$2,818.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $177.83 / $346.74	Professional		$97.72	$177.83	$346.74
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $151.36 / $288.40 / $891.25	Professional	50	$151.36	$288.40	$891.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $165.96 / $295.12	Professional		$85.11	$165.96	$295.12
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $128.82 / $245.47 / $407.38	Professional	50	$128.82	$245.47	$407.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $870.96 / $870.96 / $1,174.90	Facility		$870.96	$870.96	$1,174.90
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $158.49 / $281.84	Professional		$120.23	$158.49	$281.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $134.90 / $134.90 / $380.19	Facility		$134.90	$134.90	$380.19
CareSource Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $223.87 / $223.87	Professional		$223.87	$223.87	$223.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $724.44 / $724.44 / $724.44	Facility		$724.44	$724.44	$724.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $223.87 / $389.05	Professional		$125.89	$223.87	$389.05
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $229.09 / $426.58	Professional		$95.50	$229.09	$426.58
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $245.47 / $295.12 / $645.65	Professional	50	$245.47	$295.12	$645.65
United Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $954.99 / $2,511.89	Facility		$331.13	$954.99	$2,511.89
United Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $181.97 / $346.74	Professional		$100.00	$181.97	$346.74