Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $208.93 / $208.93 / $10,964.78	Facility		$208.93	$208.93	$10,964.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $263.03	Professional		$173.78	$173.78	$263.03
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Professional		$173.78	$173.78	$173.78
BCBS Facility/Professional Facility Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Facility		$190.55	$190.55	$190.55
BCBS Facility/Professional Professional Modifier Low / Median / High Price $190.55 / $190.55 / $190.55	Professional		$190.55	$190.55	$190.55
CareSource Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $190.55 / $257.04	Facility		$173.78	$190.55	$257.04
CareSource Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $181.97 / $398.11	Professional		$173.78	$181.97	$398.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.82 / $165.96 / $173.78	Facility		$128.82	$165.96	$173.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $173.78 / $173.78 / $190.55	Professional		$173.78	$173.78	$190.55
United Facility/Professional Facility Modifier Low / Median / High Price $173.78 / $173.78 / $173.78	Facility		$173.78	$173.78	$173.78
United Facility/Professional Professional Modifier Low / Median / High Price $165.96 / $173.78 / $204.17	Professional		$165.96	$173.78	$204.17