Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $19.95 / $95.12 / $528.04	Facility		$19.95	$95.12	$528.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.20 / $26.78 / $64.25	Professional		$19.20	$26.78	$64.25
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $96.00 / $96.00 / $96.00	Professional	25	$96.00	$96.00	$96.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.78 / $33.68 / $125.00	Professional		$22.78	$33.68	$125.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.04 / $24.05 / $35.58	Facility		$18.04	$24.05	$35.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $24.56 / $32.76 / $61.40	Professional		$24.56	$32.76	$61.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.89 / $86.35 / $132.46	Facility		$73.89	$86.35	$132.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $43.81 / $92.09	Professional		$22.00	$43.81	$92.09
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.47 / $29.54 / $59.30	Facility		$23.47	$29.54	$59.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $55.00 / $55.00	Professional		$55.00	$55.00	$55.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $23.47 / $30.17 / $59.35	Facility		$23.47	$30.17	$59.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.20 / $60.68 / $408.25	Professional		$29.20	$60.68	$408.25
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.70 / $34.41 / $81.81	Professional		$20.70	$34.41	$81.81
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $23.47 / $29.72 / $59.35	Facility		$23.47	$29.72	$59.35
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $55.00 / $55.00	Professional		$55.00	$55.00	$55.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.07 / $48.75 / $81.14	Professional		$28.07	$48.75	$81.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $58.53 / $58.53 / $58.53	Facility		$58.53	$58.53	$58.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.00 / $123.05 / $408.25	Professional		$22.00	$123.05	$408.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $34.21 / $66.58 / $76.53	Professional		$34.21	$66.58	$76.53
United Facility/Professional Professional Modifier Low / Median / High Price $27.81 / $44.56 / $89.90	Professional		$27.81	$44.56	$89.90