Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,128.36 / $1,128.36 / $1,128.36	Facility		$1,128.36	$1,128.36	$1,128.36
Aetna Facility/Professional Professional Modifier Low / Median / High Price $768.16 / $1,128.36 / $1,128.36	Professional		$768.16	$1,128.36	$1,128.36
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,624.08 / $1,624.08 / $1,624.08	Professional		$1,624.08	$1,624.08	$1,624.08
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 $1,752.55 / $2,319.55 / $2,577.28	Professional		$1,752.55	$2,319.55	$2,577.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,765.16 / $1,765.16 / $1,957.87	Facility		$1,765.16	$1,765.16	$1,957.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,765.16 / $1,765.16 / $1,765.16	Professional		$1,765.16	$1,765.16	$1,765.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $1,184.20 / $1,184.20 / $1,624.08	Facility		$1,184.20	$1,184.20	$1,624.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $864.47 / $1,184.20 / $1,586.02	Professional		$864.47	$1,184.20	$1,586.02
Qualchoice Facility/Professional Professional Modifier Low / Median / High Price $1,867.69 / $1,867.69 / $1,867.69	Professional		$1,867.69	$1,867.69	$1,867.69
United Facility/Professional Professional Modifier Low / Median / High Price $587.08 / $914.47 / $1,220.51	Professional		$587.08	$914.47	$1,220.51