Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.78 / $171.71 / $731.42	Facility		$128.78	$171.71	$731.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $129.44 / $175.09 / $350.53	Professional		$129.44	$175.09	$350.53
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $234.12 / $234.12 / $354.00	Professional	25	$234.12	$234.12	$354.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $128.80 / $175.00 / $546.49	Professional		$128.80	$175.00	$546.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $121.28 / $160.16 / $224.39	Facility		$121.28	$160.16	$224.39
CareSource Facility/Professional Professional Modifier Low / Median / High Price $163.40 / $217.81 / $408.49	Professional		$163.40	$217.81	$408.49
Cigna Facility/Professional Facility Modifier Low / Median / High Price $517.24 / $604.44 / $927.23	Facility		$517.24	$604.44	$927.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.63 / $371.82 / $715.05	Professional		$142.63	$371.82	$715.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $159.18 / $191.10 / $273.60	Facility		$159.18	$191.10	$273.60
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $162.59 / $162.59 / $162.59	Professional		$162.59	$162.59	$162.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $158.88 / $193.91 / $273.60	Facility		$158.88	$193.91	$273.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $138.87 / $281.79 / $1,234.10	Professional		$138.87	$281.79	$1,234.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $87.00 / $158.88 / $343.10	Professional		$87.00	$158.88	$343.10
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $159.18 / $194.03 / $273.60	Facility		$159.18	$194.03	$273.60
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $162.59 / $162.59 / $162.59	Professional		$162.59	$162.59	$162.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $208.99 / $344.30 / $550.20	Professional		$208.99	$344.30	$550.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $200.00 / $200.00 / $410.60	Facility		$200.00	$200.00	$410.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $148.61 / $845.15 / $1,234.10	Professional		$148.61	$845.15	$1,234.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $245.22 / $467.10 / $534.15	Professional		$245.22	$467.10	$534.15
United Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $234.92 / $532.77	Professional		$95.00	$234.92	$532.77