Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $122.75 / $1,000.00 / $3,109.00	Facility		$122.75	$1,000.00	$3,109.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $731.25 / $1,337.50 / $4,516.67	Facility	50	$731.25	$1,337.50	$4,516.67
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.97 / $181.12 / $419.26	Professional		$62.97	$181.12	$419.26
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $97.94 / $97.94 / $840.90	Professional	50	$97.94	$97.94	$840.90
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $97.48 / $97.48 / $107.76	Professional		$97.48	$97.48	$107.76
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $146.22 / $146.22 / $146.22	Professional	50	$146.22	$146.22	$146.22
BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.83 / $111.52 / $374.39	Professional		$75.83	$111.52	$374.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.06 / $87.00 / $197.60	Facility		$79.06	$87.00	$197.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $271.29 / $271.29 / $282.14	Professional		$271.29	$271.29	$282.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $99.87 / $157.78 / $400.43	Professional		$99.87	$157.78	$400.43
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $112.10 / $112.10 / $112.10	Professional		$112.10	$112.10	$112.10
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $168.16 / $168.16 / $592.61	Professional	50	$168.16	$168.16	$592.61
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $328.00 / $768.00	Facility		$130.00	$328.00	$768.00
United Facility/Professional Professional Modifier Low / Median / High Price $167.67 / $246.38 / $391.11	Professional		$167.67	$246.38	$391.11