Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $98.00 / $147.91 / $745.38	Facility		$98.00	$147.91	$745.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $103.31 / $146.78 / $325.95	Professional		$103.31	$146.78	$325.95
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $442.00 / $442.00 / $442.00	Professional	25	$442.00	$442.00	$442.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.08 / $143.60 / $446.78	Professional		$109.08	$143.60	$446.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.01 / $132.62 / $185.57	Facility		$100.01	$132.62	$185.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $134.87 / $180.35 / $337.16	Professional		$134.87	$180.35	$337.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $409.11 / $478.08 / $733.38	Facility		$409.11	$478.08	$733.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $82.00 / $194.34 / $508.76	Professional		$82.00	$194.34	$508.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $130.05 / $148.36 / $222.14	Facility		$130.05	$148.36	$222.14
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $106.71 / $106.71 / $106.71	Professional		$106.71	$106.71	$106.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $128.86 / $148.36 / $222.26	Facility		$128.86	$148.36	$222.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.96 / $211.43 / $951.21	Professional		$120.96	$211.43	$951.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $99.28 / $159.79 / $336.71	Professional		$99.28	$159.79	$336.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $130.05 / $148.36 / $222.14	Facility		$130.05	$148.36	$222.14
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $106.71 / $106.71 / $106.71	Professional		$106.71	$106.71	$106.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $154.31 / $270.39 / $450.03	Professional		$154.31	$270.39	$450.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $250.00 / $250.00 / $326.30	Facility		$250.00	$250.00	$326.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.00 / $619.65 / $951.21	Professional		$93.00	$619.65	$951.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $190.52 / $371.20 / $422.84	Professional		$190.52	$371.20	$422.84
United Facility/Professional Professional Modifier Low / Median / High Price $108.84 / $178.48 / $444.95	Professional		$108.84	$178.48	$444.95