Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $293.17 / $1,318.64 / $3,122.15	Facility		$293.17	$1,318.64	$3,122.15
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $90.39 / $115.73 / $146.59	Facility	52	$90.39	$115.73	$146.59
Aetna Facility/Professional Facility Modifier 53 Low / Median / High Price $36.15 / $90.45 / $146.63	Facility	53	$36.15	$90.45	$146.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $180.09 / $281.80 / $552.62	Professional		$180.09	$281.80	$552.62
Aetna Facility/Professional Professional Modifier 53 Low / Median / High Price $37.01 / $90.45 / $159.19	Professional	53	$37.01	$90.45	$159.19
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $226.88 / $278.04 / $449.63	Professional		$226.88	$278.04	$449.63
Ambetter Facility/Professional Professional Modifier 53 Low / Median / High Price $67.08 / $125.43 / $248.31	Professional	53	$67.08	$125.43	$248.31
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 $194.73 / $286.37 / $473.99	Professional		$194.73	$286.37	$473.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $26.47 / $143.65 / $259.88	Facility		$26.47	$143.65	$259.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $40.28 / $227.99 / $510.41	Professional		$40.28	$227.99	$510.41
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 / $301.75 / $365.40	Professional		$101.95	$301.75	$365.40
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $285.56 / $334.74 / $601.02	Professional		$285.56	$334.74	$601.02
Qualchoice Facility/Professional Professional Modifier 53 Low / Median / High Price $77.14 / $144.24 / $285.56	Professional	53	$77.14	$144.24	$285.56
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 $303.80 / $439.57 / $652.72	Professional		$303.80	$439.57	$652.72