Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $1,000.00 / $2,041.74	Facility		$151.36	$1,000.00	$2,041.74
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $794.33 / $794.33 / $812.83	Facility	50	$794.33	$794.33	$812.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $323.59	Professional		$102.33	$138.04	$323.59
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $165.96 / $363.08 / $588.84	Professional	50	$165.96	$363.08	$588.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $204.17 / $229.09	Professional		$117.49	$204.17	$229.09
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $181.97 / $223.87 / $331.13	Professional	50	$181.97	$223.87	$331.13
BCBS Facility/Professional Facility Modifier Low / Median / High Price $275.42 / $275.42 / $380.19	Facility		$275.42	$275.42	$380.19
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $151.36 / $199.53	Professional		$120.23	$151.36	$199.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $141.25 / $141.25 / $407.38	Facility		$141.25	$141.25	$407.38
CareSource Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $162.18	Professional		$162.18	$162.18	$162.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $177.83 / $245.47	Professional		$114.82	$177.83	$245.47
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $234.42 / $234.42 / $263.03	Professional		$234.42	$234.42	$263.03
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $257.04 / $331.13 / $407.38	Professional	50	$257.04	$331.13	$407.38
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $363.08 / $870.96	Facility		$128.82	$363.08	$870.96
United Facility/Professional Professional Modifier Low / Median / High Price $102.33 / $138.04 / $218.78	Professional		$102.33	$138.04	$218.78