Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $25.00 / $38.06 / $52.80	Facility		$25.00	$38.06	$52.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.28 / $20.02 / $82.83	Professional		$17.28	$20.02	$82.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $45.30 / $54.78 / $57.94	Facility		$45.30	$54.78	$57.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.40 / $10.40 / $87.18	Professional		$10.40	$10.40	$87.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $14.38 / $57.22 / $59.46	Facility		$14.38	$57.22	$59.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $67.39 / $103.38	Facility		$57.67	$67.39	$103.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.37 / $56.74 / $64.48	Professional		$24.37	$56.74	$64.48
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.76 / $18.76 / $25.28	Facility		$18.76	$18.76	$25.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $17.28 / $18.96 / $196.00	Facility		$17.28	$18.96	$196.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.64 / $21.07 / $58.36	Professional		$12.64	$21.07	$58.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $10.54 / $41.30 / $85.00	Professional		$10.54	$41.30	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.76 / $18.76 / $25.28	Facility		$18.76	$18.76	$25.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.75 / $51.48 / $247.30	Professional		$25.75	$51.48	$247.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $42.14 / $50.00 / $196.00	Facility		$42.14	$50.00	$196.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.17 / $13.88 / $20.65	Professional		$11.17	$13.88	$20.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $21.67 / $21.67 / $44.87	Professional		$21.67	$21.67	$44.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $21.67 / $83.99 / $115.04	Professional		$21.67	$83.99	$115.04
United Facility/Professional Professional Modifier Low / Median / High Price $12.64 / $17.78 / $61.80	Professional		$12.64	$17.78	$61.80