Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.25 / $102.25 / $102.25	Facility		$102.25	$102.25	$102.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.17 / $102.25 / $102.25	Professional		$57.17	$102.25	$102.25
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $87.00 / $87.00	Professional		$87.00	$87.00	$87.00
BCBS Facility/Professional Facility Modifier Low / Median / High Price $219,999.78 / $539,999.46 / $949,999.05	Facility		$219,999.78	$539,999.46	$949,999.05
BCBS Facility/Professional Professional Modifier Low / Median / High Price $158.82 / $210.20 / $233.56	Professional		$158.82	$210.20	$233.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $137.97 / $137.97 / $158.87	Facility		$137.97	$137.97	$158.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $158.87 / $158.87 / $158.87	Professional		$158.87	$158.87	$158.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.21 / $86.21 / $147.18	Facility		$86.21	$86.21	$147.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.93 / $86.21 / $143.72	Professional		$62.93	$86.21	$143.72
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $100.05 / $100.05 / $100.05	Professional		$100.05	$100.05	$100.05
United Facility/Professional Professional Modifier Low / Median / High Price $45.89 / $76.42 / $110.38	Professional		$45.89	$76.42	$110.38