Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $87.74 / $118.00 / $139.35	Facility		$87.74	$118.00	$139.35
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $441.57 / $441.57 / $441.57	Facility	25	$441.57	$441.57	$441.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.00 / $138.55 / $336.26	Professional		$68.00	$138.55	$336.26
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $133.31 / $211.62 / $387.83	Professional	25	$133.31	$211.62	$387.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.33 / $214.83 / $430.73	Professional		$113.33	$214.83	$430.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $86.34 / $86.34 / $116.56	Facility		$86.34	$86.34	$116.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $135.85 / $135.85 / $185.74	Professional		$135.85	$135.85	$185.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $628.40 / $628.40 / $762.63	Facility		$628.40	$628.40	$762.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $174.32 / $342.48	Professional		$69.73	$174.32	$342.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.09 / $117.84 / $214.75	Facility		$74.09	$117.84	$214.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $73.75 / $117.77 / $214.75	Facility		$73.75	$117.77	$214.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $123.63 / $196.72 / $592.72	Professional		$123.63	$196.72	$592.72
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $177.62 / $238.50 / $402.42	Professional	25	$177.62	$238.50	$402.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $96.65 / $154.64 / $334.81	Professional		$96.65	$154.64	$334.81
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $74.58 / $117.84 / $221.68	Facility		$74.58	$117.84	$221.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.12 / $268.77 / $430.42	Professional		$102.12	$268.77	$430.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $140.26 / $592.72 / $944.28	Professional		$140.26	$592.72	$944.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $138.77 / $303.18 / $484.94	Professional		$138.77	$303.18	$484.94
United Facility/Professional Professional Modifier Low / Median / High Price $103.92 / $178.15 / $336.54	Professional		$103.92	$178.15	$336.54