Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $118.07 / $273.47 / $381.82	Facility		$118.07	$273.47	$381.82
Aetna Facility/Professional Professional Modifier Low / Median / High Price $101.18 / $124.29 / $273.60	Professional		$101.18	$124.29	$273.60
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $100.14 / $134.00 / $356.50	Professional	25	$100.14	$134.00	$356.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.61 / $183.95 / $365.36	Professional		$110.61	$183.95	$365.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $121.26 / $155.51 / $181.89	Facility		$121.26	$155.51	$181.89
CareSource Facility/Professional Professional Modifier Low / Median / High Price $121.07 / $143.54 / $182.81	Professional		$121.07	$143.54	$182.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $348.73 / $407.52 / $541.63	Facility		$348.73	$407.52	$541.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $184.31 / $368.56	Professional		$116.36	$184.31	$368.56
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $108.84 / $123.80 / $248.08	Facility		$108.84	$123.80	$248.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $108.28 / $123.54 / $251.52	Facility		$108.28	$123.54	$251.52
Medica Facility/Professional Professional Modifier Low / Median / High Price $120.69 / $193.10 / $818.99	Professional		$120.69	$193.10	$818.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $77.91 / $131.32 / $265.86	Professional		$77.91	$131.32	$265.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $108.45 / $123.54 / $248.26	Facility		$108.45	$123.54	$248.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $196.91 / $308.42 / $422.98	Professional		$196.91	$308.42	$422.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $146.59 / $249.20 / $667.49	Facility		$146.59	$249.20	$667.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $116.36 / $560.70 / $818.99	Professional		$116.36	$560.70	$818.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $157.50 / $338.35 / $386.21	Professional		$157.50	$338.35	$386.21
United Facility/Professional Professional Modifier Low / Median / High Price $120.69 / $200.53 / $311.33	Professional		$120.69	$200.53	$311.33