Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $111.89 / $1,064.00 / $2,987.84	Facility		$111.89	$1,064.00	$2,987.84
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $731.25 / $1,309.89 / $2,495.04	Facility	50	$731.25	$1,309.89	$2,495.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.79 / $165.07 / $476.14	Professional		$54.79	$165.07	$476.14
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $79.34 / $403.02 / $1,292.75	Professional	50	$79.34	$403.02	$1,292.75
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $85.67 / $92.55 / $321.82	Professional		$85.67	$92.55	$321.82
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $128.51 / $128.51 / $142.66	Professional	50	$128.51	$128.51	$142.66
BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.38 / $97.62 / $350.80	Professional		$66.38	$97.62	$350.80
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.59 / $76.55 / $173.21	Facility		$69.59	$76.55	$173.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $254.16 / $254.16 / $264.33	Professional		$254.16	$254.16	$264.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.03 / $138.34 / $371.73	Professional		$87.03	$138.34	$371.73
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $98.52 / $98.52 / $98.52	Professional		$98.52	$98.52	$98.52
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $147.79 / $147.79 / $590.70	Professional	50	$147.79	$147.79	$590.70
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 $152.91 / $217.76 / $334.18	Professional		$152.91	$217.76	$334.18