Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.85 / $222.00 / $307.98	Facility		$26.85	$222.00	$307.98
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $141.10 / $222.00 / $433.65	Facility	CQ	$141.10	$222.00	$433.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $30.89 / $272.00	Professional		$14.98	$30.89	$272.00
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $25.39 / $25.39 / $117.80	Professional	CO	$25.39	$25.39	$117.80
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $32.74 / $114.00 / $1,719.53	Professional	CQ	$32.74	$114.00	$1,719.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $23.38 / $28.62 / $91.42	Professional		$23.38	$28.62	$91.42
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.65 / $67.48 / $67.48	Facility		$30.65	$67.48	$67.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.65 / $30.65 / $39.85	Professional		$30.65	$30.65	$39.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $100.97 / $120.86	Facility		$65.00	$100.97	$120.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.74 / $81.30 / $108.10	Professional		$28.74	$81.30	$108.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.46 / $31.41 / $69.19	Facility		$21.46	$31.41	$69.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.85 / $78.48 / $149.85	Facility		$26.85	$78.48	$149.85
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $62.75 / $127.37 / $127.37	Facility	CQ	$62.75	$127.37	$127.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.14 / $38.75 / $106.99	Professional		$31.14	$38.75	$106.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $21.51 / $48.51 / $80.86	Professional		$21.51	$48.51	$80.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.56 / $31.41 / $67.76	Facility		$21.56	$31.41	$67.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.15 / $76.36 / $107.10	Professional		$35.15	$76.36	$107.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $80.00 / $149.85	Facility		$65.00	$80.00	$149.85
Quartz Facility/Professional Facility Modifier CQ Low / Median / High Price $57.43 / $69.45 / $127.37	Facility	CQ	$57.43	$69.45	$127.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $173.60 / $216.50	Professional		$35.95	$173.60	$216.50
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 $41.94 / $94.96 / $94.96	Professional		$41.94	$94.96	$94.96
United Facility/Professional Professional Modifier Low / Median / High Price $30.26 / $34.72 / $90.00	Professional		$30.26	$34.72	$90.00