Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.09 / $92.70 / $135.94	Facility		$75.09	$92.70	$135.94
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $131.51 / $145.50 / $240.76	Facility	25	$131.51	$145.50	$240.76
Aetna Facility/Professional Professional Modifier Low / Median / High Price $72.06 / $113.43 / $248.25	Professional		$72.06	$113.43	$248.25
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $57.78 / $124.55 / $302.61	Professional	25	$57.78	$124.55	$302.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $98.47 / $133.61 / $154.94	Professional		$98.47	$133.61	$154.94
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $101.64 / $135.01 / $154.94	Professional	25	$101.64	$135.01	$154.94
BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.00 / $108.00 / $108.00	Facility		$108.00	$108.00	$108.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.22 / $102.96 / $135.40	Professional		$77.22	$102.96	$135.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $90.08 / $122.79 / $150.96	Facility		$90.08	$122.79	$150.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.69 / $153.58 / $275.36	Professional		$114.69	$153.58	$275.36
Cigna Facility/Professional Facility Modifier Low / Median / High Price $95.00 / $133.41 / $148.00	Facility		$95.00	$133.41	$148.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.19 / $108.27 / $154.63	Professional		$77.19	$108.27	$154.63
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $113.24 / $136.26 / $182.85	Professional		$113.24	$136.26	$182.85
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $116.89 / $160.09 / $183.99	Professional	25	$116.89	$160.09	$183.99
United Facility/Professional Professional Modifier Low / Median / High Price $88.34 / $110.02 / $165.65	Professional		$88.34	$110.02	$165.65