Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $123.60 / $154.50 / $229.69	Facility		$123.60	$154.50	$229.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $84.46 / $97.85 / $404.98	Professional		$84.46	$97.85	$404.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $221.45 / $267.80 / $283.25	Facility		$221.45	$267.80	$283.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.87 / $62.83 / $426.16	Professional		$50.87	$62.83	$426.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.70 / $279.70 / $290.70	Facility		$68.70	$279.70	$290.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $283.85 / $331.70 / $508.84	Facility		$283.85	$331.70	$508.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $118.12 / $277.35 / $315.18	Professional		$118.12	$277.35	$315.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $91.40 / $91.40 / $123.60	Facility		$91.40	$91.40	$123.60
Medica Facility/Professional Facility Modifier Low / Median / High Price $84.46 / $92.70 / $489.25	Facility		$84.46	$92.70	$489.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $60.42 / $103.00 / $285.31	Professional		$60.42	$103.00	$285.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.50 / $85.00 / $201.95	Professional		$51.50	$85.00	$201.95
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $91.40 / $91.40 / $123.60	Facility		$91.40	$91.40	$123.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $125.90 / $251.86 / $480.07	Professional		$125.90	$251.86	$480.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $206.00 / $206.00 / $489.25	Facility		$206.00	$206.00	$489.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.59 / $60.75 / $107.94	Professional		$54.59	$60.75	$107.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.98 / $105.98 / $219.34	Professional		$105.98	$105.98	$219.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.98 / $410.68 / $562.38	Professional		$105.98	$410.68	$562.38
United Facility/Professional Professional Modifier Low / Median / High Price $52.17 / $86.97 / $302.08	Professional		$52.17	$86.97	$302.08