Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $139.53 / $276.98	Facility		$51.31	$139.53	$276.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $58.40 / $140.25	Professional		$51.31	$58.40	$140.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $20.52 / $51.31 / $219.77	Professional		$20.52	$51.31	$219.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $61.57 / $130.33	Facility		$51.31	$61.57	$130.33
CareSource Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $53.88 / $66.50	Professional		$51.31	$53.88	$66.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.92 / $147.66 / $200.63	Facility		$111.92	$147.66	$200.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.15 / $138.16 / $157.01	Professional		$52.15	$138.16	$157.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $56.44 / $179.59	Facility		$51.31	$56.44	$179.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $123.00 / $239.04	Facility		$51.31	$123.00	$239.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $30.79 / $51.31 / $157.91	Professional		$30.79	$51.31	$157.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $51.31 / $56.44 / $179.59	Facility		$51.31	$56.44	$179.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $92.41 / $122.64 / $172.01	Professional		$92.41	$122.64	$172.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $102.62 / $123.00 / $243.72	Facility		$102.62	$123.00	$243.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.15 / $205.24 / $255.52	Professional		$52.15	$205.24	$255.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $109.27	Professional		$51.31	$51.31	$109.27
Security Health Facility/Professional Facility Modifier Low / Median / High Price $45.15 / $54.32 / $62.01	Facility		$45.15	$54.32	$62.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $51.31 / $51.31 / $280.14	Professional		$51.31	$51.31	$280.14
United Facility/Professional Professional Modifier Low / Median / High Price $35.92 / $87.90 / $218.58	Professional		$35.92	$87.90	$218.58