Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.75 / $518.00 / $2,500.00	Facility		$24.75	$518.00	$2,500.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $11.32 / $14.38 / $24.75	Professional		$11.32	$14.38	$24.75
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $18.00 / $26.55 / $38.88	Professional	50	$18.00	$26.55	$38.88
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $5.52 / $7.19 / $8.11	Professional	52	$5.52	$7.19	$8.11
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $2.21 / $2.88 / $3.24	Professional	53	$2.21	$2.88	$3.24
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $19.80 / $22.35 / $25.88	Professional		$19.80	$22.35	$25.88
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $25.00 / $35.00 / $38.82	Professional	50	$25.00	$35.00	$38.82
BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.46 / $58.46 / $70.15	Facility		$58.46	$58.46	$70.15
BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.50 / $20.51 / $20.51	Professional		$15.50	$20.51	$20.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $19.89 / $19.89 / $19.89	Facility		$19.89	$19.89	$19.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $16.68 / $17.34 / $30.75	Professional		$16.68	$17.34	$30.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $10.48 / $21.17 / $24.78	Professional		$10.48	$21.17	$24.78
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $22.77 / $24.15 / $29.76	Professional		$22.77	$24.15	$29.76
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $26.97 / $36.22 / $44.64	Professional	50	$26.97	$36.22	$44.64
United Facility/Professional Facility Modifier Low / Median / High Price $130.00 / $337.00 / $858.00	Facility		$130.00	$337.00	$858.00
United Facility/Professional Professional Modifier Low / Median / High Price $11.05 / $14.44 / $26.38	Professional		$11.05	$14.44	$26.38