Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $45.60 / $132.72	Facility		$27.30	$45.60	$132.72
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $80.00 / $100.00 / $129.26	Facility	25	$80.00	$100.00	$129.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.31 / $46.15 / $95.11	Professional		$27.31	$46.15	$95.11
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $33.00 / $60.00 / $154.94	Professional	25	$33.00	$60.00	$154.94
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $35.06 / $55.00 / $69.62	Professional		$35.06	$55.00	$69.62
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $49.42 / $56.58 / $62.38	Professional	25	$49.42	$56.58	$62.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $44.45 / $44.45 / $44.45	Facility		$44.45	$44.45	$44.45
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.97 / $37.29 / $59.26	Professional		$27.97	$37.29	$59.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.63 / $44.56 / $54.62	Facility		$32.63	$44.56	$54.62
CareSource Facility/Professional Professional Modifier Low / Median / High Price $49.91 / $67.29 / $118.91	Professional		$49.91	$67.29	$118.91
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 $28.08 / $41.94 / $60.88	Professional		$28.08	$41.94	$60.88
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $38.08 / $63.03 / $78.84	Professional		$38.08	$63.03	$78.84
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $56.83 / $65.06 / $77.48	Professional	25	$56.83	$65.06	$77.48
United Facility/Professional Professional Modifier Low / Median / High Price $36.95 / $47.52 / $70.88	Professional		$36.95	$47.52	$70.88