Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $115.20 / $200.59	Facility		$42.11	$115.20	$200.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.36 / $26.76 / $42.11	Professional		$25.36	$26.76	$42.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.44 / $91.23 / $96.50	Facility		$75.44	$91.23	$96.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $17.32 / $24.21 / $150.88	Professional		$17.32	$24.21	$150.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $42.11 / $99.03	Facility		$35.09	$42.11	$99.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $35.09 / $35.09 / $45.17	Professional		$35.09	$35.09	$45.17
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.42 / $112.67 / $172.85	Facility		$96.42	$112.67	$172.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.06 / $60.10 / $107.38	Professional		$40.06	$60.10	$107.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.82 / $35.09 / $70.18	Facility		$24.82	$35.09	$70.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $26.05 / $42.11 / $167.75	Facility		$26.05	$42.11	$167.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.98 / $30.16 / $126.32	Professional		$20.98	$30.16	$126.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $17.55 / $55.00 / $85.00	Professional		$17.55	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.82 / $35.09 / $70.18	Facility		$24.82	$35.09	$70.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.50 / $83.30 / $118.80	Professional		$57.50	$83.30	$118.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $70.18 / $70.18 / $166.68	Facility		$70.18	$70.18	$166.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.60 / $175.45 / $194.24	Professional		$18.60	$175.45	$194.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $36.11 / $74.73	Professional		$36.11	$36.11	$74.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.11 / $36.11 / $191.59	Professional		$36.11	$36.11	$191.59
United Facility/Professional Facility Modifier Low / Median / High Price $35.09 / $35.09 / $35.09	Facility		$35.09	$35.09	$35.09
United Facility/Professional Professional Modifier Low / Median / High Price $20.35 / $29.63 / $89.07	Professional		$20.35	$29.63	$89.07