Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.45 / $85.56 / $127.20	Facility		$68.45	$85.56	$127.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.92 / $70.00 / $98.89	Professional		$43.92	$70.00	$98.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.64 / $148.30 / $156.86	Facility		$122.64	$148.30	$156.86
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $22.82 / $57.04 / $244.31	Professional		$22.82	$57.04	$244.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.04 / $84.73 / $151.01	Facility		$57.04	$84.73	$151.01
CareSource Facility/Professional Professional Modifier Low / Median / High Price $57.04 / $59.89 / $73.61	Professional		$57.04	$59.89	$73.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $156.79 / $183.23 / $281.08	Facility		$156.79	$183.23	$281.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.25 / $153.59 / $174.54	Professional		$65.25	$153.59	$174.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.92 / $68.45 / $199.64	Facility		$43.92	$68.45	$199.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.34 / $68.45 / $199.64	Facility		$51.34	$68.45	$199.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.52 / $34.22 / $205.34	Professional		$28.52	$34.22	$205.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $43.92 / $68.45 / $199.64	Facility		$43.92	$68.45	$199.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $108.15 / $138.83 / $190.40	Professional		$108.15	$138.83	$190.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $254.55 / $270.94 / $270.94	Facility		$254.55	$270.94	$270.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $82.71 / $285.20 / $285.20	Professional		$82.71	$285.20	$285.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.47 / $121.47 / $121.47	Professional		$121.47	$121.47	$121.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $165.77 / $311.44 / $311.44	Professional		$165.77	$311.44	$311.44
United Facility/Professional Professional Modifier Low / Median / High Price $25.67 / $34.22 / $106.17	Professional		$25.67	$34.22	$106.17