Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.96 / $151.85 / $563.53	Facility		$25.96	$151.85	$563.53
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $118.36 / $162.22 / $162.22	Facility	CO	$118.36	$162.22	$162.22
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $57.30 / $110.57 / $423.71	Facility	CQ	$57.30	$110.57	$423.71
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $25.96 / $80.00	Professional		$12.00	$25.96	$80.00
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $17.80 / $17.80 / $17.80	Professional	CO	$17.80	$17.80	$17.80
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $34.36 / $61.66 / $110.05	Professional	CQ	$34.36	$61.66	$110.05
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $33.25 / $50.03 / $50.03	Professional	CQ	$33.25	$50.03	$50.03
BCBS Facility/Professional Facility Modifier Low / Median / High Price $30.32 / $30.32 / $39.42	Facility		$30.32	$30.32	$39.42
BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.11 / $39.11 / $39.11	Professional		$39.11	$39.11	$39.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.56 / $29.36 / $30.32	Facility		$27.56	$29.36	$30.32
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $70.00 / $85.00	Facility		$65.00	$70.00	$85.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.56 / $54.94 / $114.99	Professional		$27.56	$54.94	$114.99
Qualchoice Facility/Professional Professional Modifier CO Low / Median / High Price $42.31 / $42.31 / $42.31	Professional	CO	$42.31	$42.31	$42.31
Qualchoice Facility/Professional Professional Modifier CQ Low / Median / High Price $53.67 / $57.53 / $57.53	Professional	CQ	$53.67	$57.53	$57.53
United Facility/Professional Professional Modifier Low / Median / High Price $24.88 / $28.30 / $36.31	Professional		$24.88	$28.30	$36.31