Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $350.98 / $1,074.00 / $3,109.00	Facility		$350.98	$1,074.00	$3,109.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $759.52 / $759.52 / $759.52	Facility	50	$759.52	$759.52	$759.52
Aetna Facility/Professional Facility Modifier 54 Low / Median / High Price $253.72 / $269.55 / $296.51	Facility	54	$253.72	$269.55	$296.51
Aetna Facility/Professional Facility Modifier 55 Low / Median / High Price $50.74 / $53.91 / $59.30	Facility	55	$50.74	$53.91	$59.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $257.89 / $300.52 / $435.68	Professional		$257.89	$300.52	$435.68
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $411.72 / $411.72 / $562.74	Professional	50	$411.72	$411.72	$562.74
Aetna Facility/Professional Professional Modifier 54 Low / Median / High Price $181.56 / $263.24 / $351.27	Professional	54	$181.56	$263.24	$351.27
Aetna Facility/Professional Professional Modifier 55 Low / Median / High Price $36.31 / $52.65 / $70.25	Professional	55	$36.31	$52.65	$70.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $288.02 / $466.30 / $512.40	Professional		$288.02	$466.30	$512.40
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $538.02 / $538.02 / $708.12	Professional	50	$538.02	$538.02	$708.12
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 $329.83 / $436.55 / $485.05	Professional		$329.83	$436.55	$485.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $353.89 / $353.89 / $353.89	Facility		$353.89	$353.89	$353.89
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 $300.29 / $407.01 / $571.91	Professional		$300.29	$407.01	$571.91
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $502.56 / $570.61 / $622.30	Professional		$502.56	$570.61	$622.30
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $814.34 / $814.34 / $814.34	Professional	50	$814.34	$814.34	$814.34
United Facility/Professional Facility Modifier Low / Median / High Price $330.00 / $811.00 / $1,574.00	Facility		$330.00	$811.00	$1,574.00
United Facility/Professional Professional Modifier Low / Median / High Price $271.39 / $339.24 / $610.63	Professional		$271.39	$339.24	$610.63