Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.70 / $65.69 / $98.46	Facility		$47.70	$65.69	$98.46
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $88.50 / $88.50 / $88.50	Facility	25	$88.50	$88.50	$88.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.47 / $69.53 / $122.49	Professional		$42.47	$69.53	$122.49
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $58.28 / $105.00 / $274.00	Professional	25	$58.28	$105.00	$274.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $62.83 / $74.01 / $94.51	Professional		$62.83	$74.01	$94.51
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $74.01 / $88.53 / $96.59	Professional	25	$74.01	$88.53	$96.59
BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.05 / $49.05 / $49.05	Facility		$49.05	$49.05	$49.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.92 / $62.56 / $94.67	Professional		$46.92	$62.56	$94.67
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.50 / $59.33 / $72.86	Facility		$43.50	$59.33	$72.86
CareSource Facility/Professional Professional Modifier Low / Median / High Price $63.52 / $85.51 / $151.72	Professional		$63.52	$85.51	$151.72
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $125.00 / $148.00	Facility		$95.00	$125.00	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.27 / $69.06 / $100.77	Professional		$47.27	$69.06	$100.77
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $65.84 / $91.46 / $111.08	Professional		$65.84	$91.46	$111.08
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $85.11 / $101.81 / $107.61	Professional	25	$85.11	$101.81	$107.61
United Facility/Professional Professional Modifier Low / Median / High Price $61.13 / $75.15 / $101.74	Professional		$61.13	$75.15	$101.74