Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $180.58 / $1,074.00 / $3,109.00	Facility		$180.58	$1,074.00	$3,109.00
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $90.29 / $115.61 / $146.47	Facility	52	$90.29	$115.61	$146.47
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $36.11 / $90.23 / $146.12	Facility	53	$36.11	$90.23	$146.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.09 / $282.91 / $523.41	Professional		$180.09	$282.91	$523.41
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $37.01 / $90.23 / $158.61	Professional	53	$37.01	$90.23	$158.61
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $226.88 / $250.17 / $290.77	Professional		$226.88	$250.17	$290.77
BCBS Facility/Professional Facility Modifier Low / Median / High Price $845.19 / $845.19 / $963.52	Facility		$845.19	$845.19	$963.52
BCBS Facility/Professional Professional Modifier Low / Median / High Price $194.53 / $286.07 / $473.72	Professional		$194.53	$286.07	$473.72
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.42 / $143.06 / $259.36	Facility		$26.42	$143.06	$259.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.20 / $227.34 / $509.87	Professional		$40.20	$227.34	$509.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $458.17 / $490.00 / $816.49	Facility		$458.17	$490.00	$816.49
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.95 / $301.45 / $365.40	Professional		$101.95	$301.45	$365.40
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $260.91 / $287.70 / $334.40	Professional		$260.91	$287.70	$334.40
United Facility/Professional Facility Modifier Low / Median / High Price $304.00 / $686.00 / $1,511.00	Facility		$304.00	$686.00	$1,511.00
United Facility/Professional Professional Modifier Low / Median / High Price $303.43 / $439.57 / $646.25	Professional		$303.43	$439.57	$646.25