Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.34 / $53.77 / $161.99	Facility		$43.34	$53.77	$161.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.94 / $51.94 / $90.00	Professional		$33.94	$51.94	$90.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $42.71 / $55.52 / $67.55	Professional	25	$42.71	$55.52	$67.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $40.82 / $71.27 / $124.64	Professional		$40.82	$71.27	$124.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $34.52 / $35.04 / $45.99	Facility		$34.52	$35.04	$45.99
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.39 / $51.39 / $51.39	Professional		$51.39	$51.39	$51.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $166.71 / $194.81 / $298.83	Facility		$166.71	$194.81	$298.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.23 / $127.12 / $177.06	Professional		$66.23	$127.12	$177.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $38.79 / $53.77 / $78.84	Facility		$38.79	$53.77	$78.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.39 / $53.77 / $81.28	Facility		$37.39	$53.77	$81.28
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.36 / $82.16 / $394.41	Professional		$47.36	$82.16	$394.41
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.56 / $62.75 / $132.78	Professional		$39.56	$62.75	$132.78
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $38.79 / $53.77 / $78.84	Facility		$38.79	$53.77	$78.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.89 / $113.96 / $178.02	Professional		$63.89	$113.96	$178.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $94.88 / $94.88 / $224.03	Facility		$94.88	$94.88	$224.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.83 / $269.37 / $394.41	Professional		$71.83	$269.37	$394.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.34 / $102.88 / $129.84	Professional		$56.34	$102.88	$129.84
United Facility/Professional Professional Modifier Low / Median / High Price $47.18 / $76.97 / $108.27	Professional		$47.18	$76.97	$108.27