Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $109.20 / $145.59 / $186.17	Facility		$109.20	$145.59	$186.17
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $162.50 / $162.50 / $259.50	Facility	25	$162.50	$162.50	$259.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.20 / $163.68 / $383.23	Professional		$109.20	$163.68	$383.23
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $121.03 / $203.24 / $527.91	Professional	25	$121.03	$203.24	$527.91
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $139.93 / $177.52 / $208.81	Professional		$139.93	$177.52	$208.81
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $153.07 / $194.18 / $213.41	Professional	25	$153.07	$194.18	$213.41
BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.88 / $125.88 / $125.88	Facility		$125.88	$125.88	$125.88
BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.07 / $164.09 / $205.49	Professional		$123.07	$164.09	$205.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.81 / $168.15 / $207.90	Facility		$123.81	$168.15	$207.90
CareSource Facility/Professional Professional Modifier Low / Median / High Price $149.60 / $199.91 / $361.85	Professional		$149.60	$199.91	$361.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $135.00 / $148.00	Facility		$110.00	$135.00	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $122.88 / $166.41 / $220.63	Professional		$122.88	$166.41	$220.63
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $160.91 / $194.13 / $240.13	Professional		$160.91	$194.13	$240.13
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $143.75 / $202.43 / $245.42	Professional	25	$143.75	$202.43	$245.42
United Facility/Professional Facility Modifier Low / Median / High Price $176.00 / $188.95 / $188.95	Facility		$176.00	$188.95	$188.95
United Facility/Professional Professional Modifier Low / Median / High Price $136.85 / $167.09 / $229.41	Professional		$136.85	$167.09	$229.41