Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.81 / $234.42 / $257.04	Facility		$39.81	$234.42	$257.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $38.02 / $141.25	Professional		$30.20	$38.02	$141.25
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $281.84 / $281.84 / $281.84	Professional	22	$281.84	$281.84	$281.84
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $19.95 / $56.23 / $112.20	Professional	52	$19.95	$56.23	$112.20
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $72.44 / $169.82	Professional		$38.02	$72.44	$169.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.20 / $30.20 / $30.20	Facility		$30.20	$30.20	$30.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.86 / $112.20 / $131.83	Facility		$47.86	$112.20	$131.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $67.61 / $109.65	Professional		$32.36	$67.61	$109.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.51 / $38.90 / $77.62	Facility		$29.51	$38.90	$77.62
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $69.18 / $95.50	Professional		$45.71	$69.18	$95.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.84 / $38.90 / $93.33	Facility		$28.84	$38.90	$93.33
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $114.82 / $114.82 / $114.82	Facility	52	$114.82	$114.82	$114.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.15 / $75.86 / $281.84	Professional		$37.15	$75.86	$281.84
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $190.55 / $190.55 / $213.80	Professional	52	$190.55	$190.55	$213.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $70.79	Professional		$32.36	$33.11	$70.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $69.18 / $117.49	Professional		$33.88	$69.18	$117.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $46.77 / $53.70 / $204.17	Facility		$46.77	$53.70	$204.17
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $60.26 / $60.26 / $162.18	Facility	52	$60.26	$60.26	$162.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $75.86 / $288.40	Professional		$27.54	$75.86	$288.40
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.44 / $100.00 / $117.49	Professional		$72.44	$100.00	$117.49
United Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $44.67 / $104.71	Professional		$30.20	$44.67	$104.71