Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.00 / $30.00 / $35.00	Professional		$30.00	$30.00	$35.00
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $50.00 / $62.50	Professional		$50.00	$50.00	$62.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $50.00 / $50.00 / $75.00	Facility		$50.00	$50.00	$75.00
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $60.00 / $125.00	Facility		$45.00	$60.00	$125.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $60.00 / $125.00	Professional		$45.00	$60.00	$125.00
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $57.50 / $57.50 / $71.88	Professional		$57.50	$57.50	$71.88