Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $456.50 / $456.50 / $456.50	Facility		$456.50	$456.50	$456.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $119.00 / $605.71 / $995.06	Professional		$119.00	$605.71	$995.06
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $106.00 / $106.00 / $106.00	Professional		$106.00	$106.00	$106.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.57 / $639.07 / $1,086.03	Facility		$97.57	$639.07	$1,086.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $97.57 / $668.12 / $1,141.80	Professional		$97.57	$668.12	$1,141.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $471.86 / $750.60 / $750.60	Professional		$471.86	$750.60	$750.60
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $94.30 / $94.30 / $94.30	Professional		$94.30	$94.30	$94.30
United Facility/Professional Professional Modifier Low / Median / High Price $41.84 / $103.99 / $455.66	Professional		$41.84	$103.99	$455.66