Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $96.87 / $184.14 / $329.63	Facility		$96.87	$184.14	$329.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.05 / $76.79 / $429.00	Professional		$54.05	$76.79	$429.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $150.93 / $182.52 / $193.05	Facility		$150.93	$182.52	$193.05
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $52.00 / $52.00 / $301.86	Professional		$52.00	$52.00	$301.86
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.20 / $104.27 / $198.09	Facility		$70.20	$104.27	$198.09
CareSource Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $73.70 / $90.77	Professional		$70.20	$73.70	$90.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $192.84 / $225.35 / $345.69	Facility		$192.84	$225.35	$345.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.05 / $189.04 / $214.81	Professional		$80.05	$189.04	$214.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $54.05 / $84.24 / $245.70	Facility		$54.05	$84.24	$245.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.18 / $84.24 / $333.45	Facility		$63.18	$84.24	$333.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.97 / $52.00 / $252.72	Professional		$41.97	$52.00	$252.72
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $69.33 / $85.00	Professional		$50.00	$69.33	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $54.05 / $84.24 / $245.70	Facility		$54.05	$84.24	$245.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $141.05 / $171.17 / $238.70	Professional		$141.05	$171.17	$238.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $140.40 / $333.45 / $333.45	Facility		$140.40	$333.45	$333.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.05 / $351.00 / $351.00	Professional		$80.05	$351.00	$351.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $70.20 / $149.49	Professional		$70.20	$70.20	$149.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $70.20 / $173.40 / $383.29	Professional		$70.20	$173.40	$383.29
United Facility/Professional Professional Modifier Low / Median / High Price $36.40 / $52.00 / $181.99	Professional		$36.40	$52.00	$181.99