Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $151.36 / $173.78 / $194.98	Facility		$151.36	$173.78	$194.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $114.82 / $169.82 / $416.87	Professional		$114.82	$169.82	$416.87
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $154.88 / $177.83	Professional		$109.65	$154.88	$177.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $165.96 / $165.96 / $177.83	Facility		$165.96	$165.96	$177.83
CareSource Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $177.83 / $309.03	Professional		$131.83	$177.83	$309.03
Cigna Facility/Professional Professional Modifier Low / Median / High Price $158.49 / $190.55 / $281.84	Professional		$158.49	$190.55	$281.84
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $194.98	Professional		$190.55	$190.55	$194.98
United Facility/Professional Professional Modifier Low / Median / High Price $138.04 / $169.82 / $234.42	Professional		$138.04	$169.82	$234.42