Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.13 / $149.66 / $286.35	Facility		$70.13	$149.66	$286.35
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $79.39 / $289.44 / $379.28	Facility	25	$79.39	$289.44	$379.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.89 / $113.20 / $324.00	Professional		$65.89	$113.20	$324.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $82.62 / $175.50 / $364.80	Professional	25	$82.62	$175.50	$364.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.31 / $150.82 / $272.00	Professional		$90.31	$150.82	$272.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.43 / $98.87 / $116.84	Facility		$77.43	$98.87	$116.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $102.28 / $122.74 / $172.17	Professional		$102.28	$122.74	$172.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $295.57 / $345.39 / $459.06	Facility		$295.57	$345.39	$459.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $91.92 / $199.63 / $312.58	Professional		$91.92	$199.63	$312.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $68.61 / $95.62 / $198.80	Facility		$68.61	$95.62	$198.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.61 / $96.58 / $202.25	Facility		$68.61	$96.58	$202.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $110.51 / $237.12 / $699.27	Professional		$110.51	$237.12	$699.27
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $182.71 / $279.83 / $329.64	Professional	25	$182.71	$279.83	$329.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $78.44 / $144.45 / $265.86	Professional		$78.44	$144.45	$265.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $68.61 / $95.62 / $200.14	Facility		$68.61	$95.62	$200.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $142.55 / $243.92 / $338.25	Professional		$142.55	$243.92	$338.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $109.51 / $153.38 / $370.89	Facility		$109.51	$153.38	$370.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.38 / $475.52 / $699.27	Professional		$109.38	$475.52	$699.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $127.21 / $166.31 / $229.19	Professional		$127.21	$166.31	$229.19
United Facility/Professional Professional Modifier Low / Median / High Price $91.61 / $167.96 / $287.49	Professional		$91.61	$167.96	$287.49