Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.37 / $122.37 / $427.38	Facility		$29.37	$122.37	$427.38
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $107.88 / $107.88 / $127.93	Facility	CO	$107.88	$107.88	$127.93
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $141.10 / $282.20 / $423.30	Facility	CQ	$141.10	$282.20	$423.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.98 / $34.94 / $264.60	Professional		$14.98	$34.94	$264.60
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $54.47 / $54.47 / $54.47	Professional	CO	$54.47	$54.47	$54.47
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $27.07 / $58.74 / $302.83	Professional	CQ	$27.07	$58.74	$302.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $25.58 / $30.10 / $110.11	Professional		$25.58	$30.10	$110.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $32.84 / $76.76 / $76.76	Facility		$32.84	$76.76	$76.76
CareSource Facility/Professional Professional Modifier Low / Median / High Price $32.84 / $32.88 / $42.74	Professional		$32.84	$32.88	$42.74
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $110.97 / $132.83	Facility		$65.00	$110.97	$132.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.35 / $81.30 / $110.88	Professional		$31.35	$81.30	$110.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.48 / $34.36 / $75.44	Facility		$23.48	$34.36	$75.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.37 / $79.61 / $161.97	Facility		$29.37	$79.61	$161.97
Medica Facility/Professional Facility Modifier CO Low / Median / High Price $65.76 / $137.66 / $137.66	Facility	CO	$65.76	$137.66	$137.66
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $65.76 / $137.66 / $137.66	Facility	CQ	$65.76	$137.66	$137.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.90 / $41.10 / $127.50	Professional		$32.90	$41.10	$127.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.71 / $33.09 / $70.31	Professional		$19.71	$33.09	$70.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $23.73 / $34.36 / $75.44	Facility		$23.73	$34.36	$75.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.26 / $81.67 / $115.75	Professional		$45.26	$81.67	$115.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $85.00 / $161.97	Facility		$65.00	$85.00	$161.97
Quartz Facility/Professional Facility Modifier CO Low / Median / High Price $61.85 / $75.34 / $137.66	Facility	CO	$61.85	$75.34	$137.66
Quartz Facility/Professional Facility Modifier CQ Low / Median / High Price $61.85 / $75.34 / $137.66	Facility	CQ	$61.85	$75.34	$137.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.01 / $193.60 / $289.41	Professional		$39.01	$193.60	$289.41
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 $42.84 / $103.02 / $103.02	Professional		$42.84	$103.02	$103.02
United Facility/Professional Professional Modifier Low / Median / High Price $32.96 / $38.72 / $90.22	Professional		$32.96	$38.72	$90.22