Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.54 / $46.36 / $259.16	Facility		$34.54	$46.36	$259.16
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $17.28 / $17.28 / $20.16	Facility	52	$17.28	$17.28	$20.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.39 / $40.32 / $216.75	Professional		$33.39	$40.32	$216.75
Aetna Facility/Professional Professional Modifier 22 Low / Median / High Price $281.56 / $281.56 / $281.56	Professional	22	$281.56	$281.56	$281.56
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $15.39 / $19.75 / $67.88	Professional	52	$15.39	$19.75	$67.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.63 / $73.86 / $149.91	Professional		$37.63	$73.86	$149.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $29.56 / $29.56 / $29.56	Facility		$29.56	$29.56	$29.56
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.74 / $33.74 / $33.74	Professional		$33.74	$33.74	$33.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.20 / $114.78 / $130.43	Facility		$48.20	$114.78	$130.43
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.18 / $68.34 / $106.28	Professional		$34.18	$68.34	$106.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.84 / $40.32 / $75.64	Facility		$29.84	$40.32	$75.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.04 / $38.47 / $93.48	Facility		$29.04	$38.47	$93.48
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $115.06 / $115.06 / $115.06	Facility	52	$115.06	$115.06	$115.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.11 / $66.81 / $272.97	Professional		$37.11	$66.81	$272.97
Medica Facility/Professional Professional Modifier 52 Low / Median / High Price $190.35 / $190.35 / $212.63	Professional	52	$190.35	$190.35	$212.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.51 / $50.18 / $85.00	Professional		$21.51	$50.18	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.84 / $40.32 / $78.09	Facility		$29.84	$40.32	$78.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.01 / $85.98 / $135.24	Professional		$41.01	$85.98	$135.24
Quartz Facility/Professional Facility Modifier Low / Median / High Price $47.16 / $49.15 / $143.82	Facility		$47.16	$49.15	$143.82
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $60.78 / $115.06 / $115.06	Facility	52	$60.78	$115.06	$115.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $46.07 / $161.40 / $279.23	Professional		$46.07	$161.40	$279.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $65.42 / $100.41 / $116.19	Professional		$65.42	$100.41	$116.19
United Facility/Professional Professional Modifier Low / Median / High Price $35.08 / $57.54 / $125.07	Professional		$35.08	$57.54	$125.07