Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $331.13 / $457.09 / $537.03	Facility		$331.13	$457.09	$537.03
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $44.67 / $537.03	Professional		$32.36	$44.67	$537.03
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $794.33 / $794.33 / $794.33	Professional	AA	$794.33	$794.33	$794.33
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $295.12 / $426.58 / $549.54	Professional	QX	$295.12	$426.58	$549.54
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $295.12 / $309.03 / $489.78	Professional	QY	$295.12	$309.03	$489.78
Ambetter Facility/Professional Professional Modifier QX Low / Median / High Price $77.62 / $77.62 / $97.72	Professional	QX	$77.62	$77.62	$97.72
Ambetter Facility/Professional Professional Modifier QY Low / Median / High Price $97.72 / $97.72 / $204.17	Professional	QY	$97.72	$97.72	$204.17
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $117.49 / $141.25 / $309.03	Professional	QZ	$117.49	$141.25	$309.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $194.98	Facility		$100.00	$100.00	$194.98
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $104.71 / $251.19	Professional		$100.00	$104.71	$251.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $77.62 / $229.09	Facility		$63.10	$77.62	$229.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $208.93 / $331.13 / $501.19	Professional		$208.93	$331.13	$501.19
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $50.12 / $70.79	Professional		$39.81	$50.12	$70.79