Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.11 / $222.60 / $309.72	Facility		$39.11	$222.60	$309.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.32 / $24.51 / $31.28	Professional		$20.32	$24.51	$31.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.05 / $67.78 / $71.69	Facility		$56.05	$67.78	$71.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $10.43 / $10.43 / $106.34	Professional		$10.43	$10.43	$106.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $16.93 / $63.71 / $66.22	Facility		$16.93	$63.71	$66.22
CareSource Facility/Professional Professional Modifier Low / Median / High Price $26.07 / $26.07 / $26.07	Professional		$26.07	$26.07	$26.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $72.09 / $84.24 / $129.22	Facility		$72.09	$84.24	$129.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.15 / $70.20 / $79.78	Professional		$30.15	$70.20	$79.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $13.04 / $13.04 / $31.28	Facility		$13.04	$13.04	$31.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.04 / $111.60 / $382.33	Facility		$13.04	$111.60	$382.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $14.13 / $21.23 / $56.78	Professional		$14.13	$21.23	$56.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $13.04 / $39.11 / $85.00	Professional		$13.04	$39.11	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $13.04 / $13.04 / $31.28	Facility		$13.04	$13.04	$31.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.78 / $64.15 / $107.64	Professional		$30.78	$64.15	$107.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $52.14 / $52.14 / $127.37	Facility		$52.14	$52.14	$127.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.74 / $12.94 / $18.82	Professional		$12.74	$12.94	$18.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.52 / $55.52 / $142.55	Professional		$55.52	$55.52	$142.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.74 / $142.34 / $142.55	Professional		$91.74	$142.34	$142.55
United Facility/Professional Professional Modifier Low / Median / High Price $13.04 / $20.86 / $48.53	Professional		$13.04	$20.86	$48.53