Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $117.49 / $117.49 / $117.49	Facility		$117.49	$117.49	$117.49
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $436.52 / $436.52 / $436.52	Facility	25	$436.52	$436.52	$436.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $138.04 / $338.84	Professional		$75.86	$138.04	$338.84
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $125.89 / $186.21 / $354.81	Professional	25	$125.89	$186.21	$354.81
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.49 / $229.09 / $467.74	Professional		$117.49	$229.09	$467.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.13 / $89.13 / $120.23	Facility		$89.13	$89.13	$120.23
CareSource Facility/Professional Professional Modifier Low / Median / High Price $186.21 / $186.21 / $186.21	Professional		$186.21	$186.21	$186.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $660.69 / $660.69 / $794.33	Facility		$660.69	$660.69	$794.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.28 / $173.78 / $346.74	Professional		$81.28	$173.78	$346.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.13 / $117.49 / $223.87	Facility		$74.13	$117.49	$223.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $251.19 / $398.11	Professional		$70.79	$251.19	$398.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.44 / $109.65 / $213.80	Facility		$72.44	$109.65	$213.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.23 / $194.98 / $588.84	Professional		$120.23	$194.98	$588.84
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $177.83 / $239.88 / $398.11	Professional	25	$177.83	$239.88	$398.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $194.98	Professional		$32.36	$33.11	$194.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $223.87 / $467.74	Professional		$89.13	$223.87	$467.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.72 / $331.13 / $954.99	Professional		$97.72	$331.13	$954.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.91 / $302.00 / $489.78	Professional		$147.91	$302.00	$489.78
United Facility/Professional Professional Modifier Low / Median / High Price $85.11 / $141.25 / $288.40	Professional		$85.11	$141.25	$288.40