Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.28 / $57.86 / $86.01	Facility		$46.28	$57.86	$86.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.63 / $36.26 / $46.28	Professional		$31.63	$36.26	$46.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.93 / $100.28 / $106.07	Facility		$82.93	$100.28	$106.07
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $15.43 / $15.43 / $154.28	Professional		$15.43	$15.43	$154.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $18.28 / $94.26 / $97.97	Facility		$18.28	$94.26	$97.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $106.33 / $124.26 / $190.61	Facility		$106.33	$124.26	$190.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.19 / $103.86 / $118.03	Professional		$44.19	$103.86	$118.03
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.19 / $12.19 / $46.28	Facility		$12.19	$12.19	$46.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $12.19 / $31.63 / $183.21	Facility		$12.19	$31.63	$183.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $11.58 / $23.14 / $69.43	Professional		$11.58	$23.14	$69.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $19.09 / $55.00 / $106.45	Professional		$19.09	$55.00	$106.45
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.19 / $12.19 / $46.28	Facility		$12.19	$12.19	$46.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.96 / $91.78 / $128.72	Professional		$36.96	$91.78	$128.72
Quartz Facility/Professional Facility Modifier Low / Median / High Price $77.14 / $77.14 / $183.21	Facility		$77.14	$77.14	$183.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.82 / $9.26 / $9.26	Professional		$8.82	$9.26	$9.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $14.55 / $14.55 / $82.14	Professional		$14.55	$14.55	$82.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $14.55 / $202.49 / $210.59	Professional		$14.55	$202.49	$210.59
United Facility/Professional Professional Modifier Low / Median / High Price $11.64 / $23.14 / $69.43	Professional		$11.64	$23.14	$69.43