Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $125.35 / $135.72 / $1,616.94	Facility		$125.35	$135.72	$1,616.94
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $892.50 / $892.50 / $892.50	Facility	25	$892.50	$892.50	$892.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.56 / $118.15 / $400.00	Professional		$87.56	$118.15	$400.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $141.69 / $360.40 / $1,360.00	Professional	25	$141.69	$360.40	$1,360.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $112.22 / $134.38 / $227.10	Professional		$112.22	$134.38	$227.10
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $112.22 / $140.80 / $366.35	Professional	25	$112.22	$140.80	$366.35
BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.18 / $140.72 / $157.62	Professional		$107.18	$140.72	$157.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.41 / $134.86 / $152.87	Facility		$99.41	$134.86	$152.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $107.18 / $141.93 / $261.49	Professional		$107.18	$141.93	$261.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.66 / $132.00 / $175.26	Professional		$101.66	$132.00	$175.26
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $129.05 / $154.54 / $427.24	Professional		$129.05	$154.54	$427.24
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $129.05 / $154.54 / $261.17	Professional	25	$129.05	$154.54	$261.17
United Facility/Professional Professional Modifier Low / Median / High Price $107.06 / $126.49 / $168.48	Professional		$107.06	$126.49	$168.48
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $90.00 / $144.66	Professional	25	$80.00	$90.00	$144.66