Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $91.41 / $319.60 / $319.60	Facility		$91.41	$319.60	$319.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.53 / $92.03 / $815.00	Professional		$77.53	$92.03	$815.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $240.00 / $303.00 / $1,475.00	Facility		$240.00	$303.00	$1,475.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $74.08 / $105.51 / $284.64	Professional		$74.08	$105.51	$284.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.62 / $100.78 / $126.77	Facility		$80.62	$100.78	$126.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $79.23 / $98.96 / $126.77	Professional		$79.23	$98.96	$126.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $165.00 / $262.20 / $402.23	Facility		$165.00	$262.20	$402.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.78 / $194.52 / $301.12	Professional		$85.78	$194.52	$301.12
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $78.70 / $98.15 / $199.22	Facility		$78.70	$98.15	$199.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $78.65 / $100.68 / $224.91	Facility		$78.65	$100.68	$224.91
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.45 / $150.97 / $746.29	Professional		$80.45	$150.97	$746.29
Molina Facility/Professional Professional Modifier Low / Median / High Price $59.78 / $96.23 / $203.71	Professional		$59.78	$96.23	$203.71
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $78.65 / $98.15 / $199.25	Facility		$78.65	$98.15	$199.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.78 / $202.72 / $282.70	Professional		$138.78	$202.72	$282.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $96.79 / $202.65 / $632.91	Facility		$96.79	$202.65	$632.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $99.22 / $422.00 / $746.29	Professional		$99.22	$422.00	$746.29
Security Health Facility/Professional Facility Modifier Low / Median / High Price $461.25 / $461.25 / $461.25	Facility		$461.25	$461.25	$461.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $130.88 / $166.75 / $298.55	Professional		$130.88	$166.75	$298.55
United Facility/Professional Professional Modifier Low / Median / High Price $80.00 / $156.13 / $391.39	Professional		$80.00	$156.13	$391.39