Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.08 / $103.25 / $120.18	Facility		$30.08	$103.25	$120.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $17.48 / $23.19 / $100.28	Professional		$17.48	$23.19	$100.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $43.11 / $52.13 / $55.14	Facility		$43.11	$52.13	$55.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $9.90 / $20.05 / $86.22	Professional		$9.90	$20.05	$86.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $20.05 / $29.78 / $56.59	Facility		$20.05	$29.78	$56.59
CareSource Facility/Professional Professional Modifier Low / Median / High Price $20.05 / $21.05 / $25.94	Professional		$20.05	$21.05	$25.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.97 / $64.23 / $98.54	Facility		$54.97	$64.23	$98.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.13 / $53.99 / $61.35	Professional		$23.13	$53.99	$61.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.05 / $25.66 / $70.18	Facility		$18.05	$25.66	$70.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $18.05 / $27.40 / $94.50	Facility		$18.05	$27.40	$94.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $12.03 / $20.05 / $99.17	Professional		$12.03	$20.05	$99.17
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.05 / $65.00 / $85.00	Professional		$20.05	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.05 / $25.66 / $70.18	Facility		$18.05	$25.66	$70.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $40.29 / $52.33 / $85.27	Professional		$40.29	$52.33	$85.27
Quartz Facility/Professional Facility Modifier Low / Median / High Price $43.04 / $95.52 / $95.52	Facility		$43.04	$95.52	$95.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.91 / $106.69 / $180.90	Professional		$25.91	$106.69	$180.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.70 / $42.70 / $71.04	Professional		$42.70	$42.70	$71.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $71.04 / $71.04 / $109.47	Professional		$71.04	$71.04	$109.47
United Facility/Professional Professional Modifier Low / Median / High Price $11.77 / $16.04 / $54.95	Professional		$11.77	$16.04	$54.95