Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $107.15 / $1,071.52 / $2,511.89	Facility		$107.15	$1,071.52	$2,511.89
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $794.33 / $1,737.80 / $2,511.89	Facility	50	$794.33	$1,737.80	$2,511.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $190.55 / $776.25	Professional		$56.23	$190.55	$776.25
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.43 / $134.90 / $776.25	Professional	50	$79.43	$134.90	$776.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $100.00 / $323.59	Professional		$50.12	$100.00	$323.59
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $74.13 / $134.90 / $512.86	Professional	50	$74.13	$134.90	$512.86
BCBS Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $354.81	Professional		$263.03	$263.03	$354.81
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.86 / $75.86 / $173.78	Facility		$75.86	$75.86	$173.78
CareSource Facility/Professional Professional Modifier Low / Median / High Price $263.03 / $263.03 / $263.03	Professional		$263.03	$263.03	$263.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $138.04 / $354.81	Professional		$67.61	$138.04	$354.81
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $128.82 / $512.86	Professional		$95.50	$128.82	$512.86
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $147.91 / $169.82 / $616.60	Professional	50	$147.91	$169.82	$616.60
United Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $331.13 / $851.14	Facility		$128.82	$331.13	$851.14
United Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $147.91 / $288.40	Professional		$57.54	$147.91	$288.40