Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.03 / $151.37 / $220.48	Facility		$119.03	$151.37	$220.48
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.16 / $141.91 / $187.98	Professional		$115.16	$141.91	$187.98
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $183.74 / $184.27 / $194.44	Professional	25	$183.74	$184.27	$194.44
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $214.05 / $214.05 / $214.05	Professional		$214.05	$214.05	$214.05
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $150.00 / $150.00 / $150.00	Professional	25	$150.00	$150.00	$150.00
BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.85 / $173.31 / $254.13	Professional		$117.85	$173.31	$254.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $96.29 / $101.12 / $120.36	Facility		$96.29	$101.12	$120.36
Cigna Facility/Professional Professional Modifier Low / Median / High Price $105.39 / $174.92 / $235.39	Professional		$105.39	$174.92	$235.39
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $246.16 / $246.16 / $246.16	Professional		$246.16	$246.16	$246.16
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $172.50 / $172.50 / $172.50	Professional	25	$172.50	$172.50	$172.50
United Facility/Professional Professional Modifier Low / Median / High Price $145.88 / $179.66 / $260.95	Professional		$145.88	$179.66	$260.95