Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $17.05 / $125.70 / $328.32	Facility		$17.05	$125.70	$328.32
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $56.88 / $99.12 / $211.65	Facility	25	$56.88	$99.12	$211.65
Aetna Facility/Professional Professional Modifier Low / Median / High Price $6.85 / $20.07 / $69.34	Professional		$6.85	$20.07	$69.34
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $21.07 / $54.10 / $95.40	Professional	25	$21.07	$54.10	$95.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.49 / $23.51 / $54.22	Professional		$10.49	$23.51	$54.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.22 / $10.53 / $12.96	Facility		$8.22	$10.53	$12.96
CareSource Facility/Professional Professional Modifier Low / Median / High Price $21.19 / $25.43 / $34.90	Professional		$21.19	$25.43	$34.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.08 / $73.70 / $97.97	Facility		$63.08	$73.70	$97.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $11.50 / $24.64 / $66.11	Professional		$11.50	$24.64	$66.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $7.61 / $18.17 / $34.75	Facility		$7.61	$18.17	$34.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $7.61 / $18.17 / $39.10	Facility		$7.61	$18.17	$39.10
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $139.01 / $139.01 / $139.01	Facility	25	$139.01	$139.01	$139.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.23 / $48.48 / $489.00	Professional		$23.23	$48.48	$489.00
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $25.00 / $73.80 / $78.30	Professional	25	$25.00	$73.80	$78.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.68 / $47.14 / $70.00	Professional		$20.68	$47.14	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $7.61 / $18.17 / $36.13	Facility		$7.61	$18.17	$36.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.89 / $29.53 / $70.00	Professional		$16.89	$29.53	$70.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $16.66 / $22.50 / $489.00	Facility		$16.66	$22.50	$489.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.20 / $86.77 / $489.00	Professional		$18.20	$86.77	$489.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $15.16 / $27.52 / $48.46	Professional		$15.16	$27.52	$48.46
United Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $49.00 / $49.00	Facility		$49.00	$49.00	$49.00
United Facility/Professional Professional Modifier Low / Median / High Price $22.37 / $36.60 / $62.07	Professional		$22.37	$36.60	$62.07