Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $199.53 / $1,445.44 / $3,090.30	Facility		$199.53	$1,445.44	$3,090.30
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $588.84 / $1,949.84 / $3,630.78	Facility	50	$588.84	$1,949.84	$3,630.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $141.25 / $169.82 / $288.40	Professional		$141.25	$169.82	$288.40
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $173.78 / $354.81 / $794.33	Professional	50	$173.78	$354.81	$794.33
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $158.49 / $208.93	Professional		$114.82	$158.49	$208.93
Ambetter Facility/Professional Professional Modifier 50 Low / Median / High Price $194.98 / $257.04 / $380.19	Professional	50	$194.98	$257.04	$380.19
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,412.54 / $1,412.54 / $1,949.84	Facility		$1,412.54	$1,412.54	$1,949.84
BCBS Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $162.18 / $213.80	Professional		$162.18	$162.18	$213.80
CareSource Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $354.81	Professional		$190.55	$190.55	$354.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,737.80 / $1,737.80 / $1,737.80	Facility		$1,737.80	$1,737.80	$1,737.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $181.97 / $245.47 / $309.03	Professional		$181.97	$245.47	$309.03
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $194.98 / $263.03	Professional		$97.72	$194.98	$263.03
Qualchoice Facility/Professional Professional Modifier 50 Low / Median / High Price $363.08 / $416.87 / $457.09	Professional	50	$363.08	$416.87	$457.09
United Facility/Professional Facility Modifier Low / Median / High Price $588.84 / $1,445.44 / $4,365.16	Facility		$588.84	$1,445.44	$4,365.16
United Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $165.96 / $302.00	Professional		$131.83	$165.96	$302.00