Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $102.02 / $305.20 / $4,043.35	Facility		$102.02	$305.20	$4,043.35
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $1,251.83 / $5,548.02 / $5,548.02	Facility	25	$1,251.83	$5,548.02	$5,548.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $91.01 / $118.15 / $1,220.00	Professional		$91.01	$118.15	$1,220.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $101.12 / $769.69 / $2,520.00	Professional	25	$101.12	$769.69	$2,520.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $113.36 / $174.16 / $317.14	Professional		$113.36	$174.16	$317.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $101.01 / $126.26 / $168.15	Facility		$101.01	$126.26	$168.15
CareSource Facility/Professional Professional Modifier Low / Median / High Price $112.51 / $131.02 / $232.33	Professional		$112.51	$131.02	$232.33
Cigna Facility/Professional Facility Modifier Low / Median / High Price $310.89 / $363.30 / $557.29	Facility		$310.89	$363.30	$557.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.71 / $225.46 / $332.69	Professional		$111.71	$225.46	$332.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $91.01 / $119.14 / $242.32	Facility		$91.01	$119.14	$242.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $90.81 / $119.36 / $242.32	Facility		$90.81	$119.36	$242.32
Medica Facility/Professional Facility Modifier 25 Low / Median / High Price $692.64 / $692.64 / $692.64	Facility	25	$692.64	$692.64	$692.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $129.91 / $251.05 / $1,183.50	Professional		$129.91	$251.05	$1,183.50
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $309.41 / $449.07 / $559.79	Professional	25	$309.41	$449.07	$559.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $61.15 / $146.34 / $208.75	Professional		$61.15	$146.34	$208.75
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $90.87 / $119.00 / $239.98	Facility		$90.87	$119.00	$239.98
Quartz Facility/Professional Professional Modifier Low / Median / High Price $206.70 / $282.74 / $361.12	Professional		$206.70	$282.74	$361.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $143.15 / $481.38 / $845.00	Facility		$143.15	$481.38	$845.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $134.97 / $538.10 / $1,183.50	Professional		$134.97	$538.10	$1,183.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $188.06 / $306.07 / $345.20	Professional		$188.06	$306.07	$345.20
United Facility/Professional Professional Modifier Low / Median / High Price $123.73 / $206.17 / $323.89	Professional		$123.73	$206.17	$323.89
United Facility/Professional Professional Modifier 25 Low / Median / High Price $80.00 / $80.00 / $234.81	Professional	25	$80.00	$80.00	$234.81