Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $284.17 / $1,000.00 / $3,109.00	Facility		$284.17	$1,000.00	$3,109.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $802.50 / $1,574.14 / $7,122.98	Facility	50	$802.50	$1,574.14	$7,122.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $210.13 / $394.52 / $615.50	Professional		$210.13	$394.52	$615.50
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $280.01 / $280.01 / $1,456.05	Professional	50	$280.01	$280.01	$1,456.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $279.01 / $279.01 / $359.01	Professional		$279.01	$279.01	$359.01
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $418.51 / $418.51 / $418.51	Professional	50	$418.51	$418.51	$418.51
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,828.15 / $1,828.15 / $2,193.78	Facility		$1,828.15	$1,828.15	$2,193.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $217.57 / $319.95 / $644.34	Professional		$217.57	$319.95	$644.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $225.96 / $248.14 / $813.65	Facility		$225.96	$248.14	$813.65
CareSource Facility/Professional Professional Modifier Low / Median / High Price $474.03 / $474.03 / $492.99	Professional		$474.03	$474.03	$492.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $288.95 / $491.12 / $879.05	Professional		$288.95	$491.12	$879.05
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $320.86 / $320.86 / $320.86	Professional		$320.86	$320.86	$320.86
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $481.29 / $481.29 / $1,034.77	Professional	50	$481.29	$481.29	$1,034.77
United Facility/Professional Facility Modifier Low / Median / High Price $980.00 / $1,650.00 / $4,233.00	Facility		$980.00	$1,650.00	$4,233.00
United Facility/Professional Professional Modifier Low / Median / High Price $373.20 / $539.25 / $827.57	Professional		$373.20	$539.25	$827.57