Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.40 / $401.28 / $1,303.40	Facility		$48.40	$401.28	$1,303.40
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $10.92 / $21.57 / $67.51	Facility	52	$10.92	$21.57	$67.51
Aetna Facility/Professional Professional Modifier Low / Median / High Price $12.81 / $47.68 / $187.00	Professional		$12.81	$47.68	$187.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $6.11 / $17.48 / $35.71	Professional	52	$6.11	$17.48	$35.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.09 / $45.42 / $157.41	Professional		$14.09	$45.42	$157.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.76 / $14.96 / $18.36	Facility		$10.76	$14.96	$18.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.83 / $39.40 / $49.25	Professional		$32.83	$39.40	$49.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.93 / $117.94 / $180.92	Facility		$100.93	$117.94	$180.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $17.44 / $39.44 / $121.04	Professional		$17.44	$39.44	$121.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.21 / $33.67 / $76.28	Facility		$12.21	$33.67	$76.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.34 / $34.96 / $84.18	Facility		$12.34	$34.96	$84.18
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $42.38 / $42.38 / $42.38	Facility	52	$42.38	$42.38	$42.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.94 / $74.08 / $243.34	Professional		$42.94	$74.08	$243.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.18 / $54.09 / $73.66	Professional		$21.18	$54.09	$73.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.34 / $33.67 / $76.28	Facility		$12.34	$33.67	$76.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.40 / $65.40 / $117.92	Professional		$26.40	$65.40	$117.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $26.90 / $52.98 / $52.98	Facility		$26.90	$52.98	$52.98
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $21.52 / $42.38 / $42.38	Facility	52	$21.52	$42.38	$42.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $74.08 / $243.34	Professional		$19.17	$74.08	$243.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $48.09 / $76.91 / $252.33	Professional		$48.09	$76.91	$252.33
United Facility/Professional Professional Modifier Low / Median / High Price $40.78 / $73.02 / $169.57	Professional		$40.78	$73.02	$169.57