Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.14 / $280.62 / $1,036.80	Facility		$127.14	$280.62	$1,036.80
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $63.57 / $140.31 / $293.61	Facility	52	$63.57	$140.31	$293.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.43 / $165.97 / $329.73	Professional		$79.43	$165.97	$329.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.84 / $292.83 / $594.44	Professional		$133.84	$292.83	$594.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.48 / $90.60 / $119.59	Facility		$72.48	$90.60	$119.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $150.88 / $188.84 / $328.87	Professional		$150.88	$188.84	$328.87
Cigna Facility/Professional Facility Modifier Low / Median / High Price $379.20 / $494.59 / $675.99	Facility		$379.20	$494.59	$675.99
Cigna Facility/Professional Facility Modifier 52 Low / Median / High Price $99.71 / $99.71 / $99.71	Facility	52	$99.71	$99.71	$99.71
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.28 / $244.70 / $527.95	Professional		$111.28	$244.70	$527.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.11 / $152.41 / $314.85	Facility		$74.11	$152.41	$314.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.16 / $153.02 / $314.93	Facility		$75.16	$153.02	$314.93
Medica Facility/Professional Facility Modifier 52 Low / Median / High Price $310.81 / $310.81 / $310.81	Facility	52	$310.81	$310.81	$310.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $184.78 / $444.42 / $1,806.86	Professional		$184.78	$444.42	$1,806.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $95.68 / $236.33 / $345.27	Professional		$95.68	$236.33	$345.27
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $73.72 / $152.41 / $319.10	Facility		$73.72	$152.41	$319.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $167.01 / $276.64 / $514.94	Professional		$167.01	$276.64	$514.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $124.64 / $443.30 / $744.06	Facility		$124.64	$443.30	$744.06
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $99.71 / $310.81 / $310.81	Facility	52	$99.71	$310.81	$310.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $131.12 / $691.97 / $1,806.86	Professional		$131.12	$691.97	$1,806.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.77 / $262.45 / $566.35	Professional		$117.77	$262.45	$566.35
United Facility/Professional Professional Modifier Low / Median / High Price $174.09 / $302.29 / $635.80	Professional		$174.09	$302.29	$635.80