Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $480.00 / $540.00	Facility		$45.00	$480.00	$540.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $45.00 / $330.00	Professional		$35.00	$45.00	$330.00
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $306.00 / $306.00 / $306.00	Professional	QX	$306.00	$306.00	$306.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $36.51 / $116.22 / $1,125.00	Professional	QZ	$36.51	$116.22	$1,125.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $100.00 / $193.00	Facility		$100.00	$100.00	$193.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $100.00 / $100.00 / $155.00	Professional		$100.00	$100.00	$155.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.22 / $155.93 / $226.63	Facility		$64.22	$155.93	$226.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $61.75 / $172.90 / $420.00	Professional		$61.75	$172.90	$420.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $300.00 / $475.00	Professional		$200.00	$300.00	$475.00
Cigna Facility/Professional Professional Modifier QX Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QX	$180.00	$180.00	$180.00
Cigna Facility/Professional Professional Modifier QY Low / Median / High Price $180.00 / $180.00 / $180.00	Professional	QY	$180.00	$180.00	$180.00
United Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $52.00 / $70.00	Professional		$42.00	$52.00	$70.00