Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,214.63	Facility		$1,214.63	$1,214.63	$1,214.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $920.00 / $1,214.63 / $1,336.09	Professional		$920.00	$1,214.63	$1,336.09
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,166.05 / $1,166.05 / $1,166.05	Professional		$1,166.05	$1,166.05	$1,166.05
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,214.63	Facility		$1,214.63	$1,214.63	$1,214.63
BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,214.63 / $1,214.63 / $1,214.63	Professional		$1,214.63	$1,214.63	$1,214.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Facility		$1,238.93	$1,238.93	$1,238.93
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,001.19 / $1,238.93 / $1,238.93	Facility		$1,001.19	$1,238.93	$1,238.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,238.93 / $1,238.93 / $1,238.93	Professional		$1,238.93	$1,238.93	$1,238.93
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $1,053.08 / $1,053.08 / $1,053.08	Professional		$1,053.08	$1,053.08	$1,053.08
United Facility/Professional Professional Modifier Low / Median / High Price $485.85 / $1,214.63 / $1,238.92	Professional		$485.85	$1,214.63	$1,238.92