Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $67.61 / $131.83	Facility		$47.86	$67.61	$131.83
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $67.61 / $151.36 / $331.13	Facility	25	$67.61	$151.36	$331.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $81.28 / $154.88	Professional		$51.29	$81.28	$154.88
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $53.70 / $85.11 / $165.96	Professional	25	$53.70	$85.11	$165.96
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $123.03 / $123.03 / $123.03	Professional	50	$123.03	$123.03	$123.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $83.18 / $114.82	Professional		$56.23	$83.18	$114.82
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $67.61 / $87.10 / $112.20	Professional	25	$67.61	$87.10	$112.20
BCBS Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $74.13 / $102.33	Facility		$74.13	$74.13	$102.33
BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.86 / $69.18 / $95.50	Professional		$47.86	$69.18	$95.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $81.28 / $114.82	Facility		$63.10	$81.28	$114.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $100.00 / $199.53	Professional		$85.11	$100.00	$199.53
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.23 / $109.65 / $134.90	Facility		$56.23	$109.65	$134.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $74.13 / $120.23	Professional		$50.12	$74.13	$120.23
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $104.71 / $134.90	Professional		$72.44	$104.71	$134.90
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $75.86 / $107.15 / $134.90	Professional	25	$75.86	$107.15	$134.90
United Facility/Professional Professional Modifier Low / Median / High Price $46.77 / $64.57 / $95.50	Professional		$46.77	$64.57	$95.50