Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $24.37 / $35.07 / $93.01	Facility		$24.37	$35.07	$93.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.91 / $36.78 / $101.06	Professional		$23.91	$36.78	$101.06
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $72.50 / $123.25 / $177.56	Professional	25	$72.50	$123.25	$177.56
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $11.66 / $15.92 / $21.74	Professional	52	$11.66	$15.92	$21.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $31.81 / $53.24 / $129.03	Professional		$31.81	$53.24	$129.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $25.40 / $31.84 / $38.27	Facility		$25.40	$31.84	$38.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.63 / $42.22 / $53.98	Professional		$35.63	$42.22	$53.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $103.63 / $121.10 / $160.94	Facility		$103.63	$121.10	$160.94
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $53.91 / $108.80	Professional		$34.82	$53.91	$108.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.37 / $35.07 / $55.61	Facility		$24.37	$35.07	$55.61
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $26.28 / $26.28 / $26.28	Professional		$26.28	$26.28	$26.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $24.37 / $35.07 / $57.03	Facility		$24.37	$35.07	$57.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.78 / $82.80 / $245.75	Professional		$40.78	$82.80	$245.75
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $143.82 / $143.82 / $143.82	Professional	25	$143.82	$143.82	$143.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.72 / $34.06 / $71.18	Professional		$20.72	$34.06	$71.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.37 / $35.07 / $56.58	Facility		$24.37	$35.07	$56.58
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $26.28 / $26.28 / $26.28	Professional		$26.28	$26.28	$26.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.51 / $84.24 / $124.20	Professional		$50.51	$84.24	$124.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $35.77 / $50.62 / $140.72	Facility		$35.77	$50.62	$140.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.82 / $165.51 / $245.75	Professional		$34.82	$165.51	$245.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $46.75 / $78.43 / $114.01	Professional		$46.75	$78.43	$114.01
United Facility/Professional Professional Modifier Low / Median / High Price $37.72 / $67.06 / $132.02	Professional		$37.72	$67.06	$132.02