Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.61 / $306.24 / $432.67	Facility		$96.61	$306.24	$432.67
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $51.83 / $376.80 / $441.40	Facility	25	$51.83	$376.80	$441.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.81 / $187.28 / $480.34	Professional		$108.81	$187.28	$480.34
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $136.02 / $317.10 / $521.42	Professional	25	$136.02	$317.10	$521.42
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.32 / $234.55 / $421.31	Professional		$135.32	$234.55	$421.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $126.01 / $158.81 / $189.77	Facility		$126.01	$158.81	$189.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $153.88 / $184.54 / $258.95	Professional		$153.88	$184.54	$258.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $441.55 / $515.98 / $685.79	Facility		$441.55	$515.98	$685.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $142.77 / $320.86 / $469.26	Professional		$142.77	$320.86	$469.26
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $106.74 / $147.21 / $309.86	Facility		$106.74	$147.21	$309.86
Medica Facility/Professional Facility Modifier Low / Median / High Price $107.26 / $149.38 / $309.86	Facility		$107.26	$149.38	$309.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $168.60 / $360.48 / $1,041.60	Professional		$168.60	$360.48	$1,041.60
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $293.33 / $464.40 / $504.60	Professional	25	$293.33	$464.40	$504.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.13 / $180.28 / $348.28	Professional		$98.13	$180.28	$348.28
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $107.26 / $147.21 / $309.86	Facility		$107.26	$147.21	$309.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $216.02 / $385.11 / $506.87	Professional		$216.02	$385.11	$506.87
Quartz Facility/Professional Facility Modifier Low / Median / High Price $178.29 / $250.38 / $604.00	Facility		$178.29	$250.38	$604.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $172.76 / $713.88 / $1,041.60	Professional		$172.76	$713.88	$1,041.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $190.09 / $271.52 / $344.06	Professional		$190.09	$271.52	$344.06
United Facility/Professional Facility Modifier Low / Median / High Price $74.72 / $108.47 / $162.63	Facility		$74.72	$108.47	$162.63
United Facility/Professional Professional Modifier Low / Median / High Price $158.07 / $262.39 / $433.36	Professional		$158.07	$262.39	$433.36