Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $26.00 / $124.59 / $414.81	Facility		$26.00	$124.59	$414.81
Aetna Facility/Professional Facility Modifier CO Low / Median / High Price $255.78 / $255.78 / $255.78	Facility	CO	$255.78	$255.78	$255.78
Aetna Facility/Professional Facility Modifier CQ Low / Median / High Price $141.10 / $141.10 / $141.10	Facility	CQ	$141.10	$141.10	$141.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $14.40 / $26.71 / $182.52	Professional		$14.40	$26.71	$182.52
Aetna Facility/Professional Professional Modifier CO Low / Median / High Price $66.50 / $70.01 / $70.01	Professional	CO	$66.50	$70.01	$70.01
Aetna Facility/Professional Professional Modifier CQ Low / Median / High Price $23.26 / $23.26 / $42.79	Professional	CQ	$23.26	$23.26	$42.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.64 / $26.64 / $100.51	Professional		$22.64	$26.64	$100.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.51 / $65.98 / $65.98	Facility		$30.51	$65.98	$65.98
CareSource Facility/Professional Professional Modifier Low / Median / High Price $30.51 / $30.52 / $39.68	Professional		$30.51	$30.52	$39.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $100.35 / $117.27	Facility		$65.00	$100.35	$117.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.52 / $81.30 / $111.17	Professional		$29.52	$81.30	$111.17
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $20.75 / $32.36 / $69.29	Facility		$20.75	$32.36	$69.29
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.30 / $56.97 / $149.85	Facility		$24.30	$56.97	$149.85
Medica Facility/Professional Facility Modifier CO Low / Median / High Price $61.71 / $127.37 / $127.37	Facility	CO	$61.71	$127.37	$127.37
Medica Facility/Professional Facility Modifier CQ Low / Median / High Price $61.71 / $127.37 / $127.37	Facility	CQ	$61.71	$127.37	$127.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.76 / $35.01 / $207.96	Professional		$29.76	$35.01	$207.96
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 $22.10 / $32.36 / $66.80	Facility		$22.10	$32.36	$66.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.88 / $76.36 / $107.10	Professional		$41.88	$76.36	$107.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $79.13 / $149.85	Facility		$65.00	$79.13	$149.85
Quartz Facility/Professional Facility Modifier CO Low / Median / High Price $57.31 / $67.26 / $127.37	Facility	CO	$57.31	$67.26	$127.37
Quartz Facility/Professional Facility Modifier CQ Low / Median / High Price $57.31 / $67.26 / $127.37	Facility	CQ	$57.31	$67.26	$127.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.35 / $168.00 / $207.96	Professional		$35.35	$168.00	$207.96
Security Health Facility/Professional Facility Modifier Low / Median / High Price $74.03 / $74.03 / $74.03	Facility		$74.03	$74.03	$74.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.63 / $91.98 / $91.98	Professional		$42.63	$91.98	$91.98
United Facility/Professional Professional Modifier Low / Median / High Price $29.36 / $33.90 / $81.91	Professional		$29.36	$33.90	$81.91