Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $162.37 / $162.37 / $209.24	Facility		$162.37	$162.37	$209.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $109.47 / $159.85 / $264.25	Professional		$109.47	$159.85	$264.25
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $115.53 / $256.83 / $266.81	Professional	25	$115.53	$256.83	$266.81
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $187.02 / $220.03 / $232.45	Professional		$187.02	$220.03	$232.45
Ambetter Facility/Professional Professional Modifier 25 Low / Median / High Price $227.89 / $227.89 / $227.89	Professional	25	$227.89	$227.89	$227.89
BCBS Facility/Professional Professional Modifier Low / Median / High Price $149.08 / $197.31 / $197.31	Professional		$149.08	$197.31	$197.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $151.24 / $207.17 / $257.42	Facility		$151.24	$207.17	$257.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $147.97 / $190.28 / $353.21	Professional		$147.97	$190.28	$353.21
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.88 / $147.60 / $147.60	Professional		$88.88	$147.60	$147.60
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $222.77 / $250.53 / $267.32	Professional		$222.77	$250.53	$267.32
Qualchoice Facility/Professional Professional Modifier 25 Low / Median / High Price $262.07 / $262.07 / $262.07	Professional	25	$262.07	$262.07	$262.07
United Facility/Professional Professional Modifier Low / Median / High Price $145.40 / $187.24 / $244.29	Professional		$145.40	$187.24	$244.29