Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $128.82 / $128.82	Facility		$57.54	$128.82	$128.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.66 / $83.18 / $194.98	Professional		$42.66	$83.18	$194.98
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $75.86 / $93.33 / $208.93	Professional	25	$75.86	$93.33	$208.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.57 / $128.82 / $269.15	Professional		$64.57	$128.82	$269.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $47.86 / $64.57	Facility		$47.86	$47.86	$64.57
CareSource Facility/Professional Professional Modifier Low / Median / High Price $109.65 / $109.65 / $109.65	Professional		$109.65	$109.65	$109.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $389.05 / $389.05 / $478.63	Facility		$389.05	$389.05	$478.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $102.33 / $208.93	Professional		$43.65	$102.33	$208.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $70.79 / $128.82	Facility		$39.81	$70.79	$128.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $66.07 / $134.90 / $239.88	Professional		$66.07	$134.90	$239.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $66.07 / $117.49	Facility		$38.90	$66.07	$117.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.86 / $114.82 / $562.34	Professional		$75.86	$114.82	$562.34
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $85.11 / $169.82 / $194.98	Professional	25	$85.11	$169.82	$194.98
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $109.65	Professional		$32.36	$33.11	$109.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $53.70 / $117.49 / $288.40	Professional		$53.70	$117.49	$288.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $186.21 / $562.34	Professional		$48.98	$186.21	$562.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $70.79 / $162.18 / $288.40	Professional		$70.79	$162.18	$288.40
United Facility/Professional Professional Modifier Low / Median / High Price $44.67 / $81.28 / $165.96	Professional		$44.67	$81.28	$165.96