Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.89 / $222.00 / $469.50	Facility		$26.89	$222.00	$469.50
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $433.65 / $433.65 / $433.65	Facility	CO	$433.65	$433.65	$433.65
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $142.46 / $283.10 / $564.40	Facility	CQ	$142.46	$283.10	$564.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.39 / $49.40 / $324.00	Professional		$17.39	$49.40	$324.00
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $121.52 / $148.03 / $316.98	Professional	CO	$121.52	$148.03	$316.98
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $42.76 / $125.82 / $354.83	Professional	CQ	$42.76	$125.82	$354.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.37 / $25.12 / $80.06	Professional		$20.37	$25.12	$80.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $27.56 / $59.22 / $59.22	Facility		$27.56	$59.22	$59.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $27.54 / $27.56 / $35.79	Professional		$27.54	$27.56	$35.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $87.98 / $105.30	Facility		$65.00	$87.98	$105.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.59 / $75.70 / $108.10	Professional		$26.59	$75.70	$108.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.71 / $29.59 / $62.16	Facility		$18.71	$29.59	$62.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.40 / $107.52 / $180.05	Facility		$26.40	$107.52	$180.05
Medica Facility/Professional Facility Modifier CO Low / Median / High Price $56.39 / $114.53 / $114.53	Facility	CO	$56.39	$114.53	$114.53
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $56.39 / $114.53 / $114.53	Facility	CQ	$56.39	$114.53	$114.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $37.40 / $133.86	Professional		$28.15	$37.40	$133.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.35 / $65.00 / $102.66	Professional		$41.35	$65.00	$102.66
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.71 / $29.05 / $60.14	Facility		$18.71	$29.05	$60.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $68.65 / $96.28	Professional		$35.15	$68.65	$96.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $60.69 / $75.00 / $134.74	Facility		$60.69	$75.00	$134.74
Quartz Facility/Professional Facility Modifier CO Low / Median / High Price $51.59 / $60.50 / $114.53	Facility	CO	$51.59	$60.50	$114.53
Quartz Facility/Professional Facility Modifier CQ Low / Median / High Price $51.59 / $60.50 / $114.53	Facility	CQ	$51.59	$60.50	$114.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.32 / $150.85 / $186.26	Professional		$31.32	$150.85	$186.26
Security Health Facility/Professional Facility Modifier Low / Median / High Price $49.35 / $49.35 / $49.35	Facility		$49.35	$49.35	$49.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $39.65 / $82.70 / $82.70	Professional		$39.65	$82.70	$82.70
United Facility/Professional Professional Modifier Low / Median / High Price $26.69 / $31.17 / $72.78	Professional		$26.69	$31.17	$72.78