Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $278.37 / $1,083.00 / $3,804.00	Facility		$278.37	$1,083.00	$3,804.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $1,267.50 / $1,267.50 / $1,267.50	Facility	50	$1,267.50	$1,267.50	$1,267.50
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $178.45 / $271.63 / $329.41	Facility	54	$178.45	$271.63	$329.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $192.80 / $267.50 / $347.56	Professional		$192.80	$267.50	$347.56
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $1,751.85 / $1,751.85 / $1,751.85	Professional	50	$1,751.85	$1,751.85	$1,751.85
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $128.16 / $190.34 / $319.99	Professional	54	$128.16	$190.34	$319.99
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $24.03 / $35.69 / $55.74	Professional	55	$24.03	$35.69	$55.74
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $292.33 / $367.65 / $530.29	Professional		$292.33	$367.65	$530.29
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $518.27 / $518.27 / $518.27	Professional	50	$518.27	$518.27	$518.27
BCBS Facility/Professional Facility Modifier Low / Median / High Price $539.80 / $539.80 / $647.77	Facility		$539.80	$539.80	$647.77
BCBS Facility/Professional Professional Modifier Low / Median / High Price $218.06 / $288.61 / $343.82	Professional		$218.06	$288.61	$343.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $236.25 / $236.25 / $236.25	Facility		$236.25	$236.25	$236.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $534.97 / $534.97 / $534.97	Facility		$534.97	$534.97	$534.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $236.88 / $386.92 / $572.65	Professional		$236.88	$386.92	$572.65
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $336.18 / $397.34 / $461.10	Professional		$336.18	$397.34	$461.10
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $596.01 / $596.01 / $596.01	Professional	50	$596.01	$596.01	$596.01
United Facility/Professional Facility Modifier Low / Median / High Price $330.00 / $765.00 / $1,574.00	Facility		$330.00	$765.00	$1,574.00
United Facility/Professional Professional Modifier Low / Median / High Price $217.70 / $323.05 / $508.44	Professional		$217.70	$323.05	$508.44