Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.72 / $210.11 / $2,477.00	Facility		$39.72	$210.11	$2,477.00
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $116.45 / $210.11 / $810.51	Facility	50	$116.45	$210.11	$810.51
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $18.23 / $26.21 / $32.57	Facility	52	$18.23	$26.21	$32.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.38 / $47.03 / $93.20	Professional		$29.38	$47.03	$93.20
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $69.59 / $91.80 / $206.00	Professional	50	$69.59	$91.80	$206.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $18.02 / $21.45 / $26.21	Professional	52	$18.02	$21.45	$26.21
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $62.99 / $79.47	Professional		$39.72	$62.99	$79.47
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $93.81 / $102.17 / $115.46	Professional	50	$93.81	$102.17	$115.46
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 $32.74 / $48.04 / $63.59	Professional		$32.74	$48.04	$63.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.84 / $45.84 / $45.84	Facility		$45.84	$45.84	$45.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.20 / $56.37 / $101.89	Professional		$54.20	$56.37	$101.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.53 / $67.53 / $67.53	Facility		$67.53	$67.53	$67.53
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $61.70 / $87.83	Professional		$29.89	$61.70	$87.83
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $44.26 / $71.92 / $87.03	Professional		$44.26	$71.92	$87.03
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $107.88 / $117.50 / $132.78	Professional	50	$107.88	$117.50	$132.78
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 $44.17 / $52.55 / $89.24	Professional		$44.17	$52.55	$89.24