Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $128.82 / $144.54	Facility		$100.00	$128.82	$144.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $131.83 / $281.84	Professional		$85.11	$131.83	$281.84
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $107.15 / $134.90 / $169.82	Professional		$107.15	$134.90	$169.82
BCBS Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $131.83 / $177.83	Professional		$120.23	$131.83	$177.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.33 / $120.23 / $169.82	Facility		$93.33	$120.23	$169.82
CareSource Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $147.91 / $295.12	Professional		$125.89	$147.91	$295.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $125.89 / $125.89	Facility		$125.89	$125.89	$125.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $131.83 / $204.17	Professional		$93.33	$131.83	$204.17
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $162.18 / $173.78 / $199.53	Professional		$162.18	$173.78	$199.53
United Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $123.03 / $169.82	Professional		$89.13	$123.03	$169.82