Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $160.85 / $189.23 / $241.53	Facility		$160.85	$189.23	$241.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $144.47 / $205.86 / $495.61	Professional		$144.47	$205.86	$495.61
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $178.22 / $289.00 / $743.00	Professional	25	$178.22	$289.00	$743.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $199.61 / $247.04 / $275.70	Professional		$199.61	$247.04	$275.70
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $212.54 / $247.04 / $268.14	Professional	25	$212.54	$247.04	$268.14
BCBS Facility/Professional Facility Modifier Low / Median / High Price $164.48 / $164.48 / $164.48	Facility		$164.48	$164.48	$164.48
BCBS Facility/Professional Professional Modifier Low / Median / High Price $167.24 / $222.98 / $271.08	Professional		$167.24	$222.98	$271.08
CareSource Facility/Professional Facility Modifier Low / Median / High Price $168.36 / $228.40 / $283.02	Facility		$168.36	$228.40	$283.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $197.63 / $263.83 / $479.43	Professional		$197.63	$263.83	$479.43
Cigna Facility/Professional Facility Modifier Low / Median / High Price $110.00 / $135.00 / $186.25	Facility		$110.00	$135.00	$186.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $159.72 / $212.11 / $284.38	Professional		$159.72	$212.11	$284.38
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $218.57 / $264.77 / $307.05	Professional		$218.57	$264.77	$307.05
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $260.99 / $298.74 / $317.06	Professional	25	$260.99	$298.74	$317.06
United Facility/Professional Professional Modifier Low / Median / High Price $171.09 / $211.12 / $302.80	Professional		$171.09	$211.12	$302.80
United Facility/Professional Professional Modifier 25 Low / Median / High Price $88.00 / $88.00 / $88.00	Professional	25	$88.00	$88.00	$88.00