Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.60 / $836.00 / $1,002.00	Facility		$128.60	$836.00	$1,002.00
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $653.64 / $836.00 / $982.94	Facility	25	$653.64	$836.00	$982.94
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.56 / $69.23 / $301.32	Professional		$51.56	$69.23	$301.32
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $68.59 / $184.03 / $418.30	Professional	25	$68.59	$184.03	$418.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,119.00 / $1,163.00 / $1,418.00	Facility		$1,119.00	$1,163.00	$1,418.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.40 / $158.40 / $258.47	Professional		$67.40	$158.40	$258.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.04 / $87.63 / $177.58	Facility		$67.04	$87.63	$177.58
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.41 / $74.41 / $158.61	Professional		$67.41	$74.41	$158.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $180.22 / $210.61 / $323.08	Facility		$180.22	$210.61	$323.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.16 / $176.60 / $235.71	Professional		$77.16	$176.60	$235.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.66 / $77.29 / $172.10	Facility		$60.66	$77.29	$172.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.66 / $77.87 / $226.23	Facility		$60.66	$77.87	$226.23
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $882.60 / $882.60 / $882.60	Facility	25	$882.60	$882.60	$882.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $72.14 / $135.50 / $500.00	Professional		$72.14	$135.50	$500.00
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $117.19 / $222.99 / $401.38	Professional	25	$117.19	$222.99	$401.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $98.52 / $148.79	Professional		$50.00	$98.52	$148.79
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.40 / $77.16 / $160.75	Facility		$57.40	$77.16	$160.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $132.51 / $189.73 / $293.52	Professional		$132.51	$189.73	$293.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $319.41 / $319.41 / $319.41	Facility		$319.41	$319.41	$319.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $92.23 / $313.45 / $500.00	Professional		$92.23	$313.45	$500.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $113.74 / $232.83 / $232.83	Professional		$113.74	$232.83	$232.83
United Facility/Professional Professional Modifier Low / Median / High Price $68.48 / $125.84 / $208.13	Professional		$68.48	$125.84	$208.13