Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.44 / $128.44 / $130.65	Facility		$128.44	$128.44	$130.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.23 / $25.44 / $34.61	Professional		$19.23	$25.44	$34.61
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $9.13 / $12.72 / $15.89	Professional	52	$9.13	$12.72	$15.89
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $30.85 / $37.85 / $43.13	Professional		$30.85	$37.85	$43.13
BCBS Facility/Professional Professional Modifier Low / Median / High Price $21.56 / $28.54 / $40.47	Professional		$21.56	$28.54	$40.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.69 / $18.69 / $23.49	Facility		$18.69	$18.69	$23.49
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.46 / $24.46 / $24.95	Professional		$24.46	$24.46	$24.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $20.61 / $29.16 / $40.47	Professional		$20.61	$29.16	$40.47
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $42.68 / $43.53 / $49.60	Professional		$42.68	$43.53	$49.60
United Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $25.90 / $36.40	Professional		$19.71	$25.90	$36.40