Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $120.41 / $165.59 / $427.20	Facility		$120.41	$165.59	$427.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $115.98 / $192.97 / $563.00	Professional		$115.98	$192.97	$563.00
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $192.73 / $354.35 / $692.75	Professional	25	$192.73	$354.35	$692.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $135.72 / $223.42 / $442.97	Professional		$135.72	$223.42	$442.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $96.74 / $98.22 / $128.88	Facility		$96.74	$98.22	$128.88
CareSource Facility/Professional Professional Modifier Low / Median / High Price $168.94 / $168.94 / $168.94	Professional		$168.94	$168.94	$168.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $555.09 / $648.66 / $995.07	Facility		$555.09	$648.66	$995.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $201.07 / $380.50 / $543.66	Professional		$201.07	$380.50	$543.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $120.41 / $168.96 / $255.51	Facility		$120.41	$168.96	$255.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $118.30 / $170.19 / $282.42	Facility		$118.30	$170.19	$282.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $199.61 / $338.17 / $1,291.38	Professional		$199.61	$338.17	$1,291.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $116.87 / $185.53 / $403.55	Professional		$116.87	$185.53	$403.55
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $120.41 / $168.96 / $255.51	Facility		$120.41	$168.96	$255.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $179.16 / $327.35 / $592.14	Professional		$179.16	$327.35	$592.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $265.50 / $265.50 / $628.24	Facility		$265.50	$265.50	$628.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $261.43 / $887.76 / $1,291.38	Professional		$261.43	$887.76	$1,291.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $189.36 / $287.89 / $429.54	Professional		$189.36	$287.89	$429.54
United Facility/Professional Professional Modifier Low / Median / High Price $193.46 / $273.04 / $485.12	Professional		$193.46	$273.04	$485.12