Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $48.00 / $324.00	Facility		$48.00	$48.00	$324.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.00 / $48.00 / $288.00	Professional		$38.00	$48.00	$288.00
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $1,260.00 / $1,260.00 / $1,260.00	Professional	AA	$1,260.00	$1,260.00	$1,260.00
Ambetter Facility/Professional Professional Modifier QZ Low / Median / High Price $116.22 / $116.22 / $116.22	Professional	QZ	$116.22	$116.22	$116.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $105.92 / $306.00	Professional		$56.10	$105.92	$306.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.16 / $189.83 / $480.00	Facility		$71.16	$189.83	$480.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $68.13 / $155.93 / $244.07	Professional		$68.13	$155.93	$244.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $200.00 / $275.00 / $405.00	Professional		$200.00	$275.00	$405.00
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
Molina Facility/Professional Professional Modifier Low / Median / High Price $130.44 / $130.44 / $270.00	Professional		$130.44	$130.44	$270.00
United Facility/Professional Professional Modifier Low / Median / High Price $44.00 / $55.25 / $72.00	Professional		$44.00	$55.25	$72.00