Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $134.90 / $154.88 / $204.17	Professional		$134.90	$154.88	$204.17
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $123.03 / $229.09	Professional		$107.15	$123.03	$229.09
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $114.82 / $162.18 / $173.78	Professional	25	$114.82	$162.18	$173.78
BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.82 / $128.82 / $190.55	Professional		$128.82	$128.82	$190.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $128.82 / $131.83	Facility		$128.82	$128.82	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $177.83	Professional		$173.78	$173.78	$177.83
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $158.49 / $263.03	Professional		$147.91	$158.49	$263.03
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $186.21 / $186.21 / $186.21	Professional	25	$186.21	$186.21	$186.21
United Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $177.83 / $251.19	Professional		$117.49	$177.83	$251.19