Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.28 / $264.88 / $538.67	Facility		$78.28	$264.88	$538.67
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $262.08 / $549.25 / $2,036.96	Facility	25	$262.08	$549.25	$2,036.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $105.27 / $167.73 / $500.00	Professional		$105.27	$167.73	$500.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $126.60 / $272.64 / $523.45	Professional	25	$126.60	$272.64	$523.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.61 / $238.51 / $426.29	Professional		$136.61	$238.51	$426.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $135.31 / $171.65 / $204.66	Facility		$135.31	$171.65	$204.66
CareSource Facility/Professional Professional Modifier Low / Median / High Price $166.04 / $199.25 / $278.17	Professional		$166.04	$199.25	$278.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $480.30 / $561.27 / $745.97	Facility		$480.30	$561.27	$745.97
Cigna Facility/Professional Professional Modifier Low / Median / High Price $134.99 / $341.24 / $509.01	Professional		$134.99	$341.24	$509.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $103.60 / $151.83 / $289.02	Facility		$103.60	$151.83	$289.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $103.60 / $154.24 / $290.36	Facility		$103.60	$154.24	$290.36
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $525.95 / $525.95 / $525.95	Facility	25	$525.95	$525.95	$525.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $152.77 / $341.16 / $1,127.38	Professional		$152.77	$341.16	$1,127.38
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $303.14 / $429.30 / $491.45	Professional	25	$303.14	$429.30	$491.45
Molina Facility/Professional Professional Modifier Low / Median / High Price $98.13 / $180.28 / $337.77	Professional		$98.13	$180.28	$337.77
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $103.60 / $154.24 / $290.36	Facility		$103.60	$154.24	$290.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $231.66 / $408.07 / $545.01	Professional		$231.66	$408.07	$545.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $191.64 / $272.18 / $649.44	Facility		$191.64	$272.18	$649.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $172.15 / $774.36 / $1,127.38	Professional		$172.15	$774.36	$1,127.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $186.56 / $295.16 / $373.23	Professional		$186.56	$295.16	$373.23
United Facility/Professional Professional Modifier Low / Median / High Price $95.00 / $286.74 / $466.09	Professional		$95.00	$286.74	$466.09