Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $9.49 / $19.20 / $373.00	Facility		$9.49	$19.20	$373.00
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $42.50 / $47.09 / $653.60	Facility	CQ	$42.50	$47.09	$653.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $7.85 / $11.27 / $23.22	Professional		$7.85	$11.27	$23.22
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $42.00 / $42.00 / $42.00	Professional	CO	$42.00	$42.00	$42.00
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $13.78 / $13.85 / $14.02	Professional	CQ	$13.78	$13.85	$14.02
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $15.33 / $15.33 / $15.33	Professional		$15.33	$15.33	$15.33
Ambetter Facility/Professional Professional Modifier CO Low / Median / High Price $12.79 / $12.79 / $12.79	Professional	CO	$12.79	$12.79	$12.79
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $15.39 / $15.39 / $15.39	Professional	CQ	$15.39	$15.39	$15.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.63 / $14.53 / $27.49	Professional		$9.63	$14.53	$27.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.32 / $18.41 / $22.29	Facility		$13.32	$18.41	$22.29
CareSource Facility/Professional Professional Modifier Low / Median / High Price $13.21 / $14.39 / $18.27	Professional		$13.21	$14.39	$18.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $13.93 / $65.00 / $80.00	Facility		$13.93	$65.00	$80.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $8.86 / $37.00 / $111.17	Professional		$8.86	$37.00	$111.17
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $11.56 / $17.10 / $90.00	Professional		$11.56	$17.10	$90.00
Oscar Health Facility/Professional Facility Modifier Low / Median / High Price $61.64 / $140.66 / $173.70	Facility		$61.64	$140.66	$173.70
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $9.86 / $13.77 / $23.12	Professional		$9.86	$13.77	$23.12
United Facility/Professional Professional Modifier Low / Median / High Price $9.27 / $12.93 / $17.46	Professional		$9.27	$12.93	$17.46