Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $87.10 / $117.49	Facility		$72.44	$87.10	$117.49
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $151.36 / $151.36 / $239.88	Facility	25	$151.36	$151.36	$239.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $104.71 / $213.80	Professional		$66.07	$104.71	$213.80
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $72.44 / $114.82 / $251.19	Professional	25	$72.44	$114.82	$251.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $77.62 / $107.15 / $147.91	Professional		$77.62	$107.15	$147.91
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $85.11 / $109.65 / $144.54	Professional	25	$85.11	$109.65	$144.54
BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $100.00	Facility		$74.13	$74.13	$100.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.18 / $100.00 / $138.04	Professional		$69.18	$100.00	$138.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $100.00 / $144.54	Facility		$77.62	$100.00	$144.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $120.23 / $245.47	Professional		$104.71	$120.23	$245.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.50 / $109.65 / $134.90	Facility		$95.50	$109.65	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $104.71 / $165.96	Professional		$75.86	$104.71	$165.96
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $131.83 / $169.82	Professional		$97.72	$131.83	$169.82
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $117.49 / $138.04 / $165.96	Professional	25	$117.49	$138.04	$165.96
United Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $95.50 / $134.90	Professional		$67.61	$95.50	$134.90