Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.11 / $145.97 / $171.96	Facility		$77.11	$145.97	$171.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $78.25 / $104.32	Professional		$75.97	$78.25	$104.32
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.96 / $140.54 / $169.41	Facility		$94.96	$140.54	$169.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $75.97 / $96.48	Professional		$75.97	$75.97	$96.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $104.01 / $104.01 / $121.55	Facility		$104.01	$104.01	$121.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.97 / $239.46 / $342.29	Facility		$75.97	$239.46	$342.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.93 / $139.58 / $158.61	Professional		$73.93	$139.58	$158.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $74.86 / $74.86 / $167.51	Facility		$74.86	$74.86	$167.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $112.29 / $151.94 / $151.94	Professional		$112.29	$151.94	$151.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $74.86 / $74.86 / $164.80	Facility		$74.86	$74.86	$164.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $74.86 / $74.86 / $151.94	Professional		$74.86	$74.86	$151.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.43 / $171.85	Professional		$50.00	$70.43	$171.85
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $74.86 / $74.86 / $167.51	Facility		$74.86	$74.86	$167.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $112.29 / $151.94 / $151.94	Professional		$112.29	$151.94	$151.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $89.03 / $249.70	Professional		$75.97	$89.03	$249.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.97 / $75.97 / $624.26	Facility		$75.97	$75.97	$624.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $75.97 / $75.97	Professional		$75.97	$75.97	$75.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $106.66 / $106.66 / $106.66	Professional		$106.66	$106.66	$106.66
United Facility/Professional Facility Modifier Low / Median / High Price $75.97 / $75.97 / $75.97	Facility		$75.97	$75.97	$75.97
United Facility/Professional Professional Modifier Low / Median / High Price $75.97 / $75.97 / $121.55	Professional		$75.97	$75.97	$121.55