Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $150.66 / $150.66 / $497.45	Facility		$150.66	$150.66	$497.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $135.80 / $164.15 / $353.35	Professional		$135.80	$164.15	$353.35
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $177.42 / $177.42 / $260.77	Professional	25	$177.42	$177.42	$260.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $153.75 / $234.72 / $475.48	Professional		$153.75	$234.72	$475.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $154.28 / $197.89 / $231.42	Facility		$154.28	$197.89	$231.42
CareSource Facility/Professional Professional Modifier Low / Median / High Price $153.91 / $182.66 / $232.91	Professional		$153.91	$182.66	$232.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $442.45 / $517.04 / $687.19	Facility		$442.45	$517.04	$687.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $233.84 / $468.84	Professional		$147.60	$233.84	$468.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $149.62 / $169.06 / $330.93	Facility		$149.62	$169.06	$330.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $139.11 / $169.06 / $330.93	Facility		$139.11	$169.06	$330.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $173.87 / $287.49 / $1,045.69	Professional		$173.87	$287.49	$1,045.69
Molina Facility/Professional Professional Modifier Low / Median / High Price $97.48 / $163.89 / $333.79	Professional		$97.48	$163.89	$333.79
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $149.62 / $169.06 / $330.93	Facility		$149.62	$169.06	$330.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $249.79 / $391.24 / $536.57	Professional		$249.79	$391.24	$536.57
Quartz Facility/Professional Facility Modifier Low / Median / High Price $187.13 / $317.00 / $842.92	Facility		$187.13	$317.00	$842.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.60 / $827.90 / $1,045.69	Professional		$147.60	$827.90	$1,045.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $189.00 / $491.34 / $491.34	Professional		$189.00	$491.34	$491.34
United Facility/Professional Professional Modifier Low / Median / High Price $172.87 / $281.45 / $447.50	Professional		$172.87	$281.45	$447.50