Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.30 / $34.00 / $198.83	Facility		$24.30	$34.00	$198.83
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $406.47 / $406.47 / $406.47	Facility	CO	$406.47	$406.47	$406.47
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $71.66 / $103.94 / $217.06	Facility	CQ	$71.66	$103.94	$217.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $24.92 / $60.54	Professional		$14.40	$24.92	$60.54
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $82.20 / $456.94 / $456.94	Professional	CO	$82.20	$456.94	$456.94
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $20.55 / $50.99 / $479.86	Professional	CQ	$20.55	$50.99	$479.86
Ambetter Facility/Professional Professional Modifier CO Low / Median / High Price $25.90 / $25.90 / $25.90	Professional	CO	$25.90	$25.90	$25.90
Ambetter Facility/Professional Professional Modifier CQ Low / Median / High Price $20.68 / $20.68 / $24.61	Professional	CQ	$20.68	$20.68	$24.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $22.32 / $24.80 / $68.00	Facility		$22.32	$24.80	$68.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.61 / $19.87 / $40.35	Professional		$15.61	$19.87	$40.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.11 / $36.94 / $45.98	Facility		$32.11	$36.94	$45.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $37.81 / $47.87	Professional		$32.11	$37.81	$47.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $65.00 / $82.00	Facility		$41.01	$65.00	$82.00
Cigna Facility/Professional Facility Modifier CO Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	CO	$34.86	$34.86	$34.86
Cigna Facility/Professional Facility Modifier CQ Low / Median / High Price $34.86 / $34.86 / $34.86	Facility	CQ	$34.86	$34.86	$34.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.99 / $43.60 / $114.34	Professional		$23.99	$43.60	$114.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $16.20 / $32.34 / $32.34	Professional		$16.20	$32.34	$32.34
United Facility/Professional Professional Modifier Low / Median / High Price $25.57 / $33.56 / $39.57	Professional		$25.57	$33.56	$39.57