Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.63 / $99.37 / $131.46	Facility		$59.63	$99.37	$131.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.18 / $80.19 / $131.46	Professional		$56.18	$80.19	$131.46
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $131.52 / $131.52 / $131.52	Professional		$131.52	$131.52	$131.52
BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.56 / $54.56 / $54.56	Facility		$54.56	$54.56	$54.56
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.10 / $133.88 / $157.50	Professional		$107.10	$133.88	$157.50
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.62 / $109.62 / $109.62	Professional		$109.62	$109.62	$109.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.79 / $53.50 / $65.27	Facility		$42.79	$53.50	$65.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.82 / $105.94 / $155.19	Professional		$33.82	$105.94	$155.19
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $151.25 / $151.25 / $151.25	Professional		$151.25	$151.25	$151.25
United Facility/Professional Facility Modifier Low / Median / High Price $61.28 / $93.69 / $177.18	Facility		$61.28	$93.69	$177.18
United Facility/Professional Professional Modifier Low / Median / High Price $49.34 / $106.53 / $154.25	Professional		$49.34	$106.53	$154.25