Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.83 / $944.49 / $998.88	Facility		$73.83	$944.49	$998.88
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $193.60 / $633.60 / $978.37	Facility	25	$193.60	$633.60	$978.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.95 / $66.00 / $99.46	Professional		$52.95	$66.00	$99.46
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $64.17 / $98.26 / $311.22	Professional	25	$64.17	$98.26	$311.22
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $74.76 / $80.48 / $125.76	Professional		$74.76	$80.48	$125.76
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $74.76 / $80.48 / $242.03	Professional	25	$74.76	$80.48	$242.03
BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.50 / $75.00 / $75.00	Professional		$67.50	$75.00	$75.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.41 / $87.63 / $136.82	Facility		$67.41	$87.63	$136.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.94 / $84.11 / $93.64	Professional		$67.94	$84.11	$93.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.76 / $74.68 / $99.26	Professional		$58.76	$74.68	$99.26
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $89.67 / $99.71 / $282.26	Professional		$89.67	$99.71	$282.26
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $85.97 / $92.56 / $278.33	Professional	25	$85.97	$92.56	$278.33
United Facility/Professional Professional Modifier Low / Median / High Price $56.54 / $69.72 / $98.78	Professional		$56.54	$69.72	$98.78