Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.95 / $152.41 / $212.63	Facility		$64.95	$152.41	$212.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.36 / $74.12 / $136.96	Professional		$58.36	$74.12	$136.96
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $59.72 / $70.76 / $297.69	Professional	25	$59.72	$70.76	$297.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.26 / $120.53 / $214.62	Professional		$74.26	$120.53	$214.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.72 / $89.93 / $106.08	Facility		$70.72	$89.93	$106.08
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.87 / $90.89 / $127.15	Professional		$75.87	$90.89	$127.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $217.17 / $253.78 / $337.29	Facility		$217.17	$253.78	$337.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $83.71 / $185.91 / $262.02	Professional		$83.71	$185.91	$262.02
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $76.20 / $155.87	Facility		$63.06	$76.20	$155.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.90 / $78.25 / $155.87	Facility		$61.90	$78.25	$155.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $90.67 / $170.10 / $525.69	Professional		$90.67	$170.10	$525.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $100.30 / $203.25	Professional		$59.78	$100.30	$203.25
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $63.06 / $76.20 / $155.87	Facility		$63.06	$76.20	$155.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.80 / $194.04 / $254.37	Professional		$139.80	$194.04	$254.37
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.27 / $142.84 / $339.11	Facility		$100.27	$142.84	$339.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $94.28 / $385.50 / $525.69	Professional		$94.28	$385.50	$525.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.33 / $154.91 / $170.10	Professional		$105.33	$154.91	$170.10
United Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $149.04 / $231.38	Professional		$86.98	$149.04	$231.38
United Facility/Professional Professional Modifier 25 Low / Median / High Price $98.97 / $98.97 / $99.10	Professional	25	$98.97	$98.97	$99.10