Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $388.85 / $1,152.78 / $2,812.00	Facility		$388.85	$1,152.78	$2,812.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $2,812.00 / $3,178.50 / $3,667.50	Facility	50	$2,812.00	$3,178.50	$3,667.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $266.12 / $828.30 / $1,268.06	Professional		$266.12	$828.30	$1,268.06
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $2,030.31 / $2,030.31 / $2,030.31	Professional	50	$2,030.31	$2,030.31	$2,030.31
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $431.52 / $497.98 / $1,570.33	Professional		$431.52	$497.98	$1,570.33
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $719.61 / $719.61 / $1,647.00	Professional	50	$719.61	$719.61	$1,647.00
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 $321.47 / $425.48 / $477.04	Professional		$321.47	$425.48	$477.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $349.04 / $349.04 / $349.04	Facility		$349.04	$349.04	$349.04
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 $315.18 / $588.70 / $1,337.09	Professional		$315.18	$588.70	$1,337.09
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $496.25 / $595.98 / $1,805.88	Professional		$496.25	$595.98	$1,805.88
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 $302.30 / $623.37 / $1,528.36	Professional		$302.30	$623.37	$1,528.36