Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.70 / $70.27 / $209.19	Facility		$52.70	$70.27	$209.19
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $280.33 / $280.33 / $280.33	Facility	25	$280.33	$280.33	$280.33
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.97 / $80.89 / $362.90	Professional		$54.97	$80.89	$362.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.29 / $120.17 / $251.30	Professional		$82.29	$120.17	$251.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.84 / $96.25 / $117.69	Facility		$77.84	$96.25	$117.69
CareSource Facility/Professional Professional Modifier Low / Median / High Price $76.47 / $95.59 / $181.91	Professional		$76.47	$95.59	$181.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $211.76 / $247.46 / $379.61	Facility		$211.76	$247.46	$379.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.00 / $200.30 / $260.42	Professional		$78.00	$200.30	$260.42
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $70.27 / $100.02 / $197.10	Facility		$70.27	$100.02	$197.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.27 / $103.12 / $197.10	Facility		$70.27	$103.12	$197.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $98.10 / $191.45 / $613.55	Professional		$98.10	$191.45	$613.55
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.53 / $96.23 / $207.99	Professional		$59.53	$96.23	$207.99
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.53 / $95.97 / $197.10	Facility		$64.53	$95.97	$197.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $196.85 / $279.36	Professional		$147.60	$196.85	$279.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $373.71 / $373.71 / $373.71	Facility		$373.71	$373.71	$373.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $110.81 / $489.35 / $613.55	Professional		$110.81	$489.35	$613.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $166.96 / $236.15 / $326.95	Professional		$166.96	$236.15	$326.95
United Facility/Professional Professional Modifier Low / Median / High Price $95.04 / $163.78 / $264.50	Professional		$95.04	$163.78	$264.50