Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $660.69	Facility		$47.86	$47.86	$660.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $47.86 / $575.44	Professional		$32.36	$47.86	$575.44
Aetna Facility/Professional Professional Modifier AA Low / Median / High Price $389.05 / $616.60 / $1,479.11	Professional	AA	$389.05	$616.60	$1,479.11
Aetna Facility/Professional Professional Modifier QX Low / Median / High Price $263.03 / $346.74 / $537.03	Professional	QX	$263.03	$346.74	$537.03
Aetna Facility/Professional Professional Modifier QY Low / Median / High Price $218.78 / $295.12 / $489.78	Professional	QY	$218.78	$295.12	$489.78
Aetna Facility/Professional Professional Modifier QZ Low / Median / High Price $120.23 / $138.04 / $436.52	Professional	QZ	$120.23	$138.04	$436.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $213.80 / $213.80 / $741.31	Professional		$213.80	$213.80	$741.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $251.19 / $338.84 / $575.44	Professional		$251.19	$338.84	$575.44
Cigna Facility/Professional Professional Modifier AA Low / Median / High Price $691.83 / $691.83 / $794.33	Professional	AA	$691.83	$691.83	$794.33
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.26 / $74.13 / $120.23	Facility		$60.26	$74.13	$120.23
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $57.54 / $95.50	Professional		$41.69	$57.54	$95.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $2,691.53 / $2,691.53	Facility		$2,691.53	$2,691.53	$2,691.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.90 / $69.18 / $1,348.96	Professional		$30.90	$69.18	$1,348.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $54.95 / $70.79 / $478.63	Professional		$54.95	$70.79	$478.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $363.08 / $389.05 / $602.56	Professional		$363.08	$389.05	$602.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $275.42 / $630.96 / $1,348.96	Professional		$275.42	$630.96	$1,348.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $831.76 / $831.76	Professional		$416.87	$831.76	$831.76
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $60.26 / $93.33	Professional		$30.20	$60.26	$93.33