Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $116.18 / $803.00 / $2,812.00	Facility		$116.18	$803.00	$2,812.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $790.92 / $790.92 / $790.92	Facility	50	$790.92	$790.92	$790.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.26 / $114.66 / $214.01	Professional		$87.26	$114.66	$214.01
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $124.56 / $208.15 / $1,354.05	Professional	50	$124.56	$208.15	$1,354.05
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $99.69 / $160.28 / $173.15	Professional		$99.69	$160.28	$173.15
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $223.54 / $240.42 / $279.01	Professional	50	$223.54	$240.42	$279.01
BCBS Facility/Professional Facility Modifier Low / Median / High Price $338.29 / $338.29 / $405.95	Facility		$338.29	$338.29	$405.95
BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.40 / $128.91 / $159.01	Professional		$97.40	$128.91	$159.01
CareSource Facility/Professional Facility Modifier Low / Median / High Price $106.70 / $106.70 / $106.70	Facility		$106.70	$106.70	$106.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $325.61 / $325.61 / $325.61	Facility		$325.61	$325.61	$325.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $102.66 / $174.65 / $345.00	Professional		$102.66	$174.65	$345.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $171.38 / $184.32 / $213.91	Professional		$171.38	$184.32	$213.91
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $257.07 / $257.07 / $320.86	Professional	50	$257.07	$257.07	$320.86
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 $89.80 / $137.28 / $312.00	Professional		$89.80	$137.28	$312.00