Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.16 / $119.16 / $150.97	Facility		$119.16	$119.16	$150.97
Aetna Facility/Professional Facility Modifier 25 Low / Median / High Price $178.71 / $178.71 / $197.93	Facility	25	$178.71	$178.71	$197.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $108.29 / $150.97 / $212.50	Professional		$108.29	$150.97	$212.50
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $192.57 / $192.57 / $261.39	Professional	25	$192.57	$192.57	$261.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $147.76 / $235.19 / $444.17	Professional		$147.76	$235.19	$444.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $443.35 / $518.09 / $688.59	Facility		$443.35	$518.09	$688.59
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $230.63 / $420.65	Professional		$147.90	$230.63	$420.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $119.16 / $154.22 / $259.70	Facility		$119.16	$154.22	$259.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $119.16 / $152.29 / $262.19	Facility		$119.16	$152.29	$262.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $148.47 / $294.95 / $1,045.69	Professional		$148.47	$294.95	$1,045.69
Medica Facility/Professional Professional Modifier 25 Low / Median / High Price $321.30 / $321.30 / $321.30	Professional	25	$321.30	$321.30	$321.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.52 / $165.51 / $344.18	Professional		$97.52	$165.51	$344.18
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $119.16 / $154.22 / $262.19	Facility		$119.16	$154.22	$262.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $233.40 / $379.06 / $509.03	Professional		$233.40	$379.06	$509.03
Quartz Facility/Professional Facility Modifier Low / Median / High Price $174.07 / $248.84 / $653.54	Facility		$174.07	$248.84	$653.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.90 / $714.69 / $1,045.69	Professional		$147.90	$714.69	$1,045.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $222.50 / $385.68 / $492.31	Professional		$222.50	$385.68	$492.31
United Facility/Professional Professional Modifier Low / Median / High Price $151.69 / $266.43 / $436.39	Professional		$151.69	$266.43	$436.39