Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $75.92 / $539.10 / $871.50	Facility		$75.92	$539.10	$871.50
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $334.40 / $504.00 / $630.79	Facility	25	$334.40	$504.00	$630.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.11 / $45.98 / $186.60	Professional		$28.11	$45.98	$186.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $442.00 / $459.00 / $561.00	Facility		$442.00	$459.00	$561.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.96 / $92.45 / $155.25	Professional		$39.96	$92.45	$155.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.67 / $51.88 / $80.00	Facility		$39.67	$51.88	$80.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $43.94 / $93.97	Professional		$39.90	$43.94	$93.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $124.26 / $190.61	Facility		$106.33	$124.26	$190.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.56 / $111.56 / $139.44	Professional		$45.56	$111.56	$139.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $49.57 / $114.94	Facility		$35.40	$49.57	$114.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $53.12 / $121.22	Facility		$35.40	$53.12	$121.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.39 / $77.22 / $500.00	Professional		$44.39	$77.22	$500.00
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.49 / $58.40 / $94.90	Professional		$27.49	$58.40	$94.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $35.40 / $49.57 / $96.65	Facility		$35.40	$49.57	$96.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.50 / $112.40 / $172.44	Professional		$78.50	$112.40	$172.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $189.21 / $189.21 / $189.21	Facility		$189.21	$189.21	$189.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.51 / $209.00 / $500.00	Professional		$54.51	$209.00	$500.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.95 / $136.77 / $151.84	Professional		$75.95	$136.77	$151.84
United Facility/Professional Professional Modifier Low / Median / High Price $44.36 / $70.52 / $127.24	Professional		$44.36	$70.52	$127.24