Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $128.31 / $128.31 / $128.31	Facility		$128.31	$128.31	$128.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $79.18 / $114.22 / $148.59	Professional		$79.18	$114.22	$148.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $177.20 / $322.50 / $322.50	Facility		$177.20	$322.50	$322.50
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $164.80 / $177.20 / $219.77	Professional		$164.80	$177.20	$219.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.49 / $17.52 / $52.09	Facility		$12.49	$17.52	$52.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.12 / $129.12 / $468.58	Facility		$129.12	$129.12	$468.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $129.12 / $202.50 / $253.13	Professional		$129.12	$202.50	$253.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.99 / $137.47 / $206.22	Facility		$27.99	$137.47	$206.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $29.21 / $29.21 / $161.74	Professional		$29.21	$29.21	$161.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.99 / $202.94 / $911.54	Facility		$27.99	$202.94	$911.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $76.23 / $131.35 / $202.18	Professional		$76.23	$131.35	$202.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $90.00 / $123.77	Professional		$55.00	$90.00	$123.77
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.99 / $137.47 / $206.22	Facility		$27.99	$137.47	$206.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $29.21 / $29.21 / $161.74	Professional		$29.21	$29.21	$161.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.79 / $41.02 / $53.26	Professional		$19.79	$41.02	$53.26
Quartz Facility/Professional Facility Modifier Low / Median / High Price $129.12 / $309.64 / $911.54	Facility		$129.12	$309.64	$911.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $129.12 / $129.12 / $131.69	Professional		$129.12	$129.12	$131.69
United Facility/Professional Professional Modifier Low / Median / High Price $69.09 / $110.75 / $202.18	Professional		$69.09	$110.75	$202.18