Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.46 / $198.24 / $356.00	Facility		$42.46	$198.24	$356.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $88.64 / $292.45 / $850.90	Facility	25	$88.64	$292.45	$850.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.53 / $51.28 / $147.60	Professional		$28.53	$51.28	$147.60
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $33.70 / $73.80 / $152.80	Professional	25	$33.70	$73.80	$152.80
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $37.04 / $66.93 / $124.97	Professional		$37.04	$66.93	$124.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.15 / $42.42 / $52.21	Facility		$33.15	$42.42	$52.21
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.76 / $62.11 / $86.15	Professional		$51.76	$62.11	$86.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $151.38 / $176.91 / $235.13	Facility		$151.38	$176.91	$235.13
Cigna Facility/Professional Facility Modifier 62 Low / Median / High Price $29.37 / $29.37 / $29.37	Facility	62	$29.37	$29.37	$29.37
Cigna Facility/Professional Facility Modifier AS Low / Median / High Price $4.70 / $4.70 / $4.70	Facility	AS	$4.70	$4.70	$4.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.65 / $86.42 / $159.46	Professional		$37.65	$86.42	$159.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.19 / $44.35 / $86.26	Facility		$26.19	$44.35	$86.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.13 / $44.35 / $86.26	Facility		$26.13	$44.35	$86.26
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $109.29 / $109.29 / $109.29	Facility	25	$109.29	$109.29	$109.29
Medica Facility/Professional Facility Modifier 62 Low / Median / High Price $93.75 / $99.33 / $99.33	Facility	62	$93.75	$99.33	$99.33
Medica Facility/Professional Facility Modifier AS Low / Median / High Price $15.00 / $15.89 / $15.89	Facility	AS	$15.00	$15.89	$15.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.45 / $97.57 / $354.09	Professional		$46.45	$97.57	$354.09
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $83.63 / $117.18 / $146.40	Professional	25	$83.63	$117.18	$146.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.03 / $72.22 / $132.78	Professional		$41.03	$72.22	$132.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.79 / $44.55 / $86.26	Facility		$26.79	$44.55	$86.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.18 / $110.50 / $170.00	Professional		$61.18	$110.50	$170.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $46.99 / $66.40 / $176.74	Facility		$46.99	$66.40	$176.74
Quartz Facility/Professional Facility Modifier 62 Low / Median / High Price $29.37 / $41.50 / $99.33	Facility	62	$29.37	$41.50	$99.33
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $4.70 / $6.64 / $15.89	Facility	AS	$4.70	$6.64	$15.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $46.53 / $223.86 / $354.09	Professional		$46.53	$223.86	$354.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.06 / $72.01 / $116.92	Professional		$55.06	$72.01	$116.92
United Facility/Professional Professional Modifier Low / Median / High Price $46.19 / $85.59 / $117.81	Professional		$46.19	$85.59	$117.81