Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $131.18 / $332.14 / $486.77	Facility		$131.18	$332.14	$486.77
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $161.91 / $458.15 / $562.79	Facility	25	$161.91	$458.15	$562.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $140.97 / $216.38 / $675.90	Professional		$140.97	$216.38	$675.90
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $207.18 / $498.23 / $765.06	Professional	25	$207.18	$498.23	$765.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $178.50 / $309.54 / $556.48	Professional		$178.50	$309.54	$556.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $171.43 / $215.76 / $258.32	Facility		$171.43	$215.76	$258.32
CareSource Facility/Professional Professional Modifier Low / Median / High Price $203.53 / $243.54 / $342.51	Professional		$203.53	$243.54	$342.51
Cigna Facility/Professional Facility Modifier Low / Median / High Price $582.12 / $680.26 / $904.12	Facility		$582.12	$680.26	$904.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $182.13 / $426.56 / $618.28	Professional		$182.13	$426.56	$618.28
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $144.80 / $194.40 / $402.68	Facility		$144.80	$194.40	$402.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $144.80 / $195.36 / $402.68	Facility		$144.80	$195.36	$402.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $211.12 / $439.69 / $1,377.15	Professional		$211.12	$439.69	$1,377.15
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $422.17 / $585.90 / $638.78	Professional	25	$422.17	$585.90	$638.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $137.08 / $252.51 / $478.38	Professional		$137.08	$252.51	$478.38
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $145.11 / $194.40 / $402.68	Facility		$145.11	$194.40	$402.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $293.22 / $509.12 / $669.47	Professional		$293.22	$509.12	$669.47
Quartz Facility/Professional Facility Modifier Low / Median / High Price $242.44 / $340.32 / $822.00	Facility		$242.44	$340.32	$822.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $224.61 / $940.59 / $1,377.15	Professional		$224.61	$940.59	$1,377.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $249.10 / $369.04 / $453.33	Professional		$249.10	$369.04	$453.33
United Facility/Professional Professional Modifier Low / Median / High Price $204.46 / $343.30 / $555.41	Professional		$204.46	$343.30	$555.41
United Facility/Professional Professional Modifier 25 Low / Median / High Price $88.00 / $90.00 / $90.00	Professional	25	$88.00	$90.00	$90.00