Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.70 / $99.00 / $129.25	Facility		$70.70	$99.00	$129.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.09 / $122.27 / $279.95	Professional		$64.09	$122.27	$279.95
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $72.23 / $133.16 / $300.00	Professional	25	$72.23	$133.16	$300.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.33 / $180.96 / $360.75	Professional		$91.33	$180.96	$360.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $69.52 / $69.52 / $93.85	Facility		$69.52	$69.52	$93.85
CareSource Facility/Professional Professional Modifier Low / Median / High Price $114.56 / $114.56 / $156.51	Professional		$114.56	$114.56	$156.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $531.83 / $531.83 / $645.42	Facility		$531.83	$531.83	$645.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.59 / $145.15 / $281.42	Professional		$62.59	$145.15	$281.42
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $61.42 / $98.54 / $181.26	Facility		$61.42	$98.54	$181.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.67 / $97.50 / $181.26	Facility		$59.67	$97.50	$181.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $96.99 / $171.13 / $476.78	Professional		$96.99	$171.13	$476.78
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $204.43 / $222.75 / $389.00	Professional	25	$204.43	$222.75	$389.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $58.91 / $93.15 / $209.85	Professional		$58.91	$93.15	$209.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $61.42 / $98.54 / $187.10	Facility		$61.42	$98.54	$187.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $92.29 / $217.16 / $364.20	Professional		$92.29	$217.16	$364.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $113.75 / $476.78 / $797.90	Professional		$113.75	$476.78	$797.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $115.14 / $243.88 / $409.51	Professional		$115.14	$243.88	$409.51
United Facility/Professional Professional Modifier Low / Median / High Price $111.90 / $156.58 / $307.68	Professional		$111.90	$156.58	$307.68