Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $3,747.64 / $3,747.64 / $3,747.64	Professional		$3,747.64	$3,747.64	$3,747.64
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $2,881.16 / $2,881.16 / $5,218.38	Professional		$2,881.16	$2,881.16	$5,218.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $715.00 / $715.71 / $794.61	Facility		$715.00	$715.71	$794.61
CareSource Facility/Professional Professional Modifier Low / Median / High Price $715.00 / $715.00 / $793.84	Professional		$715.00	$715.00	$793.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $5,106.14 / $5,106.14 / $5,106.14	Facility		$5,106.14	$5,106.14	$5,106.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $560.27 / $5,106.14 / $5,106.14	Professional		$560.27	$5,106.14	$5,106.14
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $3,680.00 / $3,680.00 / $6,001.14	Professional		$3,680.00	$3,680.00	$6,001.14
United Facility/Professional Professional Modifier Low / Median / High Price $1,394.64 / $2,418.87 / $3,796.20	Professional		$1,394.64	$2,418.87	$3,796.20