Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $253.92 / $305.80 / $2,424.50	Facility		$253.92	$305.80	$2,424.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $902.46 / $1,134.75 / $1,382.42	Facility	25	$902.46	$1,134.75	$1,382.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $179.24 / $245.58 / $770.05	Professional		$179.24	$245.58	$770.05
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $196.83 / $311.72 / $1,259.35	Professional	25	$196.83	$311.72	$1,259.35
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $224.18 / $268.44 / $454.92	Professional		$224.18	$268.44	$454.92
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $224.18 / $284.87 / $730.02	Professional	25	$224.18	$284.87	$730.02
BCBS Facility/Professional Facility Modifier Low / Median / High Price $373.53 / $373.53 / $373.53	Facility		$373.53	$373.53	$373.53
BCBS Facility/Professional Professional Modifier Low / Median / High Price $244.46 / $280.93 / $359.50	Professional		$244.46	$280.93	$359.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $198.84 / $269.39 / $306.18	Facility		$198.84	$269.39	$306.18
CareSource Facility/Professional Professional Modifier Low / Median / High Price $243.90 / $324.97 / $592.88	Professional		$243.90	$324.97	$592.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $207.02 / $276.51 / $383.00	Professional		$207.02	$276.51	$383.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $257.81 / $298.98 / $340.45	Professional		$257.81	$298.98	$340.45
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $257.81 / $324.36 / $839.52	Professional	25	$257.81	$324.36	$839.52
United Facility/Professional Professional Modifier Low / Median / High Price $232.70 / $287.27 / $377.92	Professional		$232.70	$287.27	$377.92