Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.72 / $58.00 / $127.65	Facility		$46.72	$58.00	$127.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.72 / $83.96 / $190.96	Professional		$46.72	$83.96	$190.96
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $72.92 / $96.95 / $224.49	Professional	25	$72.92	$96.95	$224.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.34 / $127.12 / $255.04	Professional		$60.34	$127.12	$255.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.04 / $46.04 / $62.15	Facility		$46.04	$46.04	$62.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.63 / $80.63 / $110.03	Professional		$80.63	$80.63	$110.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $376.48 / $376.48 / $456.90	Facility		$376.48	$376.48	$456.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.87 / $100.38 / $204.45	Professional		$46.87	$100.38	$204.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.52 / $70.03 / $127.70	Facility		$39.52	$70.03	$127.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.94 / $67.75 / $127.70	Facility		$38.94	$67.75	$127.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $70.73 / $112.62 / $340.85	Professional		$70.73	$112.62	$340.85
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $84.56 / $99.00 / $170.10	Professional	25	$84.56	$99.00	$170.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $93.15 / $200.74	Professional		$58.91	$93.15	$200.74
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.71 / $70.03 / $127.70	Facility		$39.71	$70.03	$127.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.40 / $148.97 / $257.08	Professional		$85.40	$148.97	$257.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.68 / $329.60 / $563.47	Professional		$75.68	$329.60	$563.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $67.12 / $161.51 / $289.49	Professional		$67.12	$161.51	$289.49
United Facility/Professional Professional Modifier Low / Median / High Price $67.36 / $107.86 / $215.73	Professional		$67.36	$107.86	$215.73