Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $103.91 / $286.35	Facility		$41.01	$103.91	$286.35
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $222.71 / $286.35 / $286.35	Facility	25	$222.71	$286.35	$286.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.64 / $69.14 / $208.28	Professional		$38.64	$69.14	$208.28
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $38.96 / $108.00 / $237.60	Professional	25	$38.96	$108.00	$237.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.59 / $94.77 / $179.99	Professional		$55.59	$94.77	$179.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.21 / $56.55 / $69.59	Facility		$44.21	$56.55	$69.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $65.78 / $78.94 / $109.68	Professional		$65.78	$78.94	$109.68
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.84 / $225.35 / $299.51	Facility		$192.84	$225.35	$299.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.16 / $116.04 / $203.48	Professional		$58.16	$116.04	$203.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $62.16 / $128.06	Facility		$41.01	$62.16	$128.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $62.16 / $132.53	Facility		$41.01	$62.16	$132.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.25 / $153.97 / $456.37	Professional		$75.25	$153.97	$456.37
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $125.60 / $203.28 / $229.52	Professional	25	$125.60	$203.28	$229.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.54 / $85.00 / $139.59	Professional		$41.54	$85.00	$139.59
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $41.01 / $62.16 / $129.33	Facility		$41.01	$62.16	$129.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $84.00 / $141.44 / $216.80	Professional		$84.00	$141.44	$216.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $69.61 / $89.16 / $264.00	Facility		$69.61	$89.16	$264.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.03 / $302.33 / $456.37	Professional		$71.03	$302.33	$456.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $100.75 / $149.19	Professional		$78.00	$100.75	$149.19
United Facility/Professional Professional Modifier Low / Median / High Price $72.43 / $121.13 / $197.21	Professional		$72.43	$121.13	$197.21