Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.93 / $39.93 / $56.14	Facility		$39.93	$39.93	$56.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.68 / $51.52 / $72.08	Professional		$35.68	$51.52	$72.08
Aetna Facility/Professional Professional Modifier 25 Low / Median / High Price $54.29 / $54.29 / $54.29	Professional	25	$54.29	$54.29	$54.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $167.61 / $195.86 / $300.45	Facility		$167.61	$195.86	$300.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.95 / $71.17 / $116.05	Professional		$55.95	$71.17	$116.05
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.93 / $56.14 / $78.59	Facility		$39.93	$56.14	$78.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.93 / $56.14 / $79.86	Facility		$39.93	$56.14	$79.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.02 / $128.91 / $386.12	Professional		$71.02	$128.91	$386.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.56 / $61.81 / $134.51	Professional		$39.56	$61.81	$134.51
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.93 / $56.14 / $78.59	Facility		$39.93	$56.14	$78.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.69 / $99.50 / $183.07	Professional		$55.69	$99.50	$183.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $83.46 / $83.46 / $216.24	Facility		$83.46	$83.46	$216.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.95 / $269.45 / $386.12	Professional		$55.95	$269.45	$386.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.53 / $90.51 / $129.88	Professional		$69.53	$90.51	$129.88
United Facility/Professional Professional Modifier Low / Median / High Price $70.18 / $105.57 / $226.95	Professional		$70.18	$105.57	$226.95