Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $115.91 / $115.91 / $115.91	Facility		$115.91	$115.91	$115.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.28 / $101.51 / $131.90	Professional		$70.28	$101.51	$131.90
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $173.10 / $315.04 / $315.04	Facility		$173.10	$315.04	$315.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $160.97 / $161.00 / $233.68	Professional		$160.97	$161.00	$233.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.06 / $97.95 / $370.48	Facility		$13.06	$97.95	$370.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $111.50 / $111.50 / $446.05	Facility		$111.50	$111.50	$446.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $111.50 / $193.50 / $241.88	Professional		$111.50	$193.50	$241.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.66 / $145.22 / $208.75	Facility		$57.66	$145.22	$208.75
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $120.59 / $120.59 / $217.82	Professional		$120.59	$120.59	$217.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.66 / $217.82 / $782.12	Facility		$57.66	$217.82	$782.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.69 / $100.77 / $210.71	Professional		$75.69	$100.77	$210.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $83.73 / $114.43	Professional		$55.00	$83.73	$114.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.66 / $145.22 / $208.75	Facility		$57.66	$145.22	$208.75
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $120.59 / $120.59 / $217.82	Professional		$120.59	$120.59	$217.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.85 / $38.65 / $50.19	Professional		$22.85	$38.65	$50.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $111.50 / $336.16 / $782.12	Facility		$111.50	$336.16	$782.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $111.50 / $111.50 / $129.57	Professional		$111.50	$111.50	$129.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $181.53 / $181.53 / $181.53	Professional		$181.53	$181.53	$181.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $181.53 / $181.53 / $181.53	Professional		$181.53	$181.53	$181.53
United Facility/Professional Professional Modifier Low / Median / High Price $66.86 / $98.02 / $181.53	Professional		$66.86	$98.02	$181.53