Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.13 / $40.85 / $123.10	Facility		$30.13	$40.85	$123.10
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.15 / $39.76 / $91.17	Professional		$28.15	$39.76	$91.17
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $37.21 / $37.21 / $51.58	Professional	25	$37.21	$37.21	$51.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.70 / $49.55 / $94.94	Professional		$27.70	$49.55	$94.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $23.83 / $24.17 / $31.74	Facility		$23.83	$24.17	$31.74
CareSource Facility/Professional Professional Modifier Low / Median / High Price $38.79 / $38.79 / $38.79	Professional		$38.79	$38.79	$38.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.86 / $150.58 / $231.00	Facility		$128.86	$150.58	$231.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.70 / $96.53 / $135.56	Professional		$45.70	$96.53	$135.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.77 / $39.71 / $57.36	Facility		$29.77	$39.71	$57.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.38 / $39.71 / $60.26	Facility		$29.38	$39.71	$60.26
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.12 / $75.80 / $298.80	Professional		$44.12	$75.80	$298.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.56 / $61.81 / $132.93	Professional		$39.56	$61.81	$132.93
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.77 / $39.71 / $57.36	Facility		$29.77	$39.71	$57.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.03 / $77.86 / $135.18	Professional		$44.03	$77.86	$135.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $66.18 / $66.18 / $154.38	Facility		$66.18	$66.18	$154.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $206.24 / $298.80	Professional		$55.00	$206.24	$298.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $38.45 / $101.89 / $141.12	Professional		$38.45	$101.89	$141.12
United Facility/Professional Professional Modifier Low / Median / High Price $43.32 / $63.02 / $102.05	Professional		$43.32	$63.02	$102.05