Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.62 / $77.62 / $104.71	Facility		$77.62	$77.62	$104.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $114.82 / $173.78	Professional		$57.54	$114.82	$173.78
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $56.23 / $85.11 / $102.33	Professional		$56.23	$85.11	$102.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $85.11 / $85.11 / $91.20	Facility		$85.11	$85.11	$91.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $91.20 / $158.49	Professional		$67.61	$91.20	$158.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $91.20 / $128.82	Professional		$72.44	$91.20	$128.82
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $97.72 / $102.33	Professional		$97.72	$97.72	$102.33
United Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $79.43 / $107.15	Professional		$66.07	$79.43	$107.15