Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.63 / $42.18 / $125.47	Facility		$31.63	$42.18	$125.47
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $125.13 / $125.13 / $125.13	Facility	25	$125.13	$125.13	$125.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.63 / $46.86 / $142.00	Professional		$31.63	$46.86	$142.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $49.10 / $124.65 / $191.68	Professional	25	$49.10	$124.65	$191.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $36.70 / $68.02 / $112.89	Professional		$36.70	$68.02	$112.89
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.22 / $57.02 / $69.59	Facility		$46.22	$57.02	$69.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.49 / $56.86 / $107.55	Professional		$45.49	$56.86	$107.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.96 / $149.53 / $229.38	Facility		$127.96	$149.53	$229.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.76 / $116.33 / $137.19	Professional		$39.76	$116.33	$137.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $38.56 / $53.96 / $104.99	Facility		$38.56	$53.96	$104.99
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.86 / $54.14 / $98.30	Facility		$38.86	$54.14	$98.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.62 / $76.40 / $350.74	Professional		$41.62	$76.40	$350.74
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $160.91 / $160.91 / $160.91	Professional	25	$160.91	$160.91	$160.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.49 / $58.40 / $92.01	Professional		$27.49	$58.40	$92.01
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $37.75 / $53.96 / $98.30	Facility		$37.75	$53.96	$98.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $84.48 / $115.16 / $157.94	Professional		$84.48	$115.16	$157.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $221.04 / $221.04 / $221.04	Facility		$221.04	$221.04	$221.04
Quartz Facility/Professional Facility Modifier AS Low / Median / High Price $22.10 / $22.10 / $22.10	Facility	AS	$22.10	$22.10	$22.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.66 / $208.71 / $350.74	Professional		$55.66	$208.71	$350.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.08 / $142.37 / $142.37	Professional		$66.08	$142.37	$142.37
United Facility/Professional Professional Modifier Low / Median / High Price $40.03 / $66.29 / $104.32	Professional		$40.03	$66.29	$104.32