Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.29 / $133.13 / $389.19	Facility		$22.29	$133.13	$389.19
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $55.91 / $140.47 / $152.25	Facility	CO	$55.91	$140.47	$152.25
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $36.49 / $90.45 / $361.04	Facility	CQ	$36.49	$90.45	$361.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.00 / $22.29 / $64.13	Professional		$12.00	$22.29	$64.13
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $58.40 / $58.40 / $58.40	Professional	CO	$58.40	$58.40	$58.40
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $42.64 / $61.96 / $354.83	Professional	CQ	$42.64	$61.96	$354.83
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $20.92 / $27.61 / $27.61	Professional	CQ	$20.92	$27.61	$27.61
BCBS Facility/Professional Facility Modifier Low / Median / High Price $31.77 / $44.84 / $58.12	Facility		$31.77	$44.84	$58.12
BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.75 / $63.00 / $90.00	Professional		$27.75	$63.00	$90.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $15.00 / $27.00 / $41.31	Facility		$15.00	$27.00	$41.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $31.67 / $35.83	Professional		$27.54	$31.67	$35.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $53.50 / $65.00 / $65.00	Facility		$53.50	$65.00	$65.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.60 / $43.41 / $113.94	Professional		$23.60	$43.41	$113.94
Health Alliance Plan Facility/Professional Facility Modifier Low / Median / High Price $22.29 / $159.93 / $404.96	Facility		$22.29	$159.93	$404.96
Health Alliance Plan Facility/Professional Facility Modifier CO Low / Median / High Price $55.91 / $119.46 / $176.09	Facility	CO	$55.91	$119.46	$176.09
Health Alliance Plan Facility/Professional Facility Modifier CQ Low / Median / High Price $55.18 / $99.41 / $369.74	Facility	CQ	$55.18	$99.41	$369.74
Health Alliance Plan Facility/Professional Professional Modifier Low / Median / High Price $19.29 / $27.17 / $59.85	Professional		$19.29	$27.17	$59.85
Health Alliance Plan Facility/Professional Professional Modifier CQ Low / Median / High Price $42.64 / $64.59 / $299.87	Professional	CQ	$42.64	$64.59	$299.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.11 / $18.96 / $75.00	Professional		$16.11	$18.96	$75.00
United Facility/Professional Professional Modifier Low / Median / High Price $25.13 / $27.33 / $32.75	Professional		$25.13	$27.33	$32.75