Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.34 / $57.34 / $219.38	Facility		$57.34	$57.34	$219.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.34 / $67.56 / $79.23	Professional		$57.34	$67.56	$79.23
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.00 / $179.51 / $371.50	Professional		$94.00	$179.51	$371.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.29 / $303.10 / $478.15	Facility		$80.29	$303.10	$478.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $80.29 / $177.45 / $201.65	Professional		$80.29	$177.45	$201.65
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.31 / $85.50 / $115.70	Facility		$60.31	$85.50	$115.70
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $79.36 / $79.36 / $79.36	Professional		$79.36	$79.36	$79.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.86 / $96.71 / $115.70	Facility		$72.86	$96.71	$115.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.04 / $63.23 / $210.94	Professional		$33.04	$63.23	$210.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $85.00 / $346.23	Professional		$55.00	$85.00	$346.23
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $60.31 / $85.50 / $115.70	Facility		$60.31	$85.50	$115.70
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $79.36 / $79.36 / $79.36	Professional		$79.36	$79.36	$79.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $182.24 / $230.33 / $321.20	Professional		$182.24	$230.33	$321.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $516.83 / $516.83 / $516.83	Facility		$516.83	$516.83	$516.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.29 / $500.05 / $633.60	Professional		$80.29	$500.05	$633.60
United Facility/Professional Professional Modifier Low / Median / High Price $38.88 / $60.01 / $115.01	Professional		$38.88	$60.01	$115.01