Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.51 / $139.68 / $160.40	Facility		$73.51	$139.68	$160.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $73.51 / $98.01	Professional		$71.37	$73.51	$98.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.21 / $132.03 / $159.16	Facility		$89.21	$132.03	$159.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $71.37 / $96.34	Professional		$71.37	$71.37	$96.34
CareSource Facility/Professional Facility Modifier Low / Median / High Price $114.19 / $128.47 / $130.81	Facility		$114.19	$128.47	$130.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.37 / $88.08 / $181.15	Facility		$71.37	$88.08	$181.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $85.51 / $121.15	Professional		$70.95	$85.51	$121.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $60.77 / $71.37 / $78.51	Facility		$60.77	$71.37	$78.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $104.76 / $142.74 / $142.74	Professional		$104.76	$142.74	$142.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.77 / $69.84 / $77.22	Facility		$60.77	$69.84	$77.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $69.84 / $77.75 / $288.38	Professional		$69.84	$77.75	$288.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $67.63 / $85.00	Professional		$50.00	$67.63	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $60.42 / $71.37 / $78.51	Facility		$60.42	$71.37	$78.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $104.76 / $142.74 / $142.74	Professional		$104.76	$142.74	$142.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $97.53 / $202.00	Professional		$71.37	$97.53	$202.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $71.37 / $71.37 / $338.15	Facility		$71.37	$71.37	$338.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $120.16 / $288.38	Professional		$71.37	$120.16	$288.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $65.38 / $100.20 / $100.20	Professional		$65.38	$100.20	$100.20
United Facility/Professional Professional Modifier Low / Median / High Price $71.37 / $75.65 / $90.29	Professional		$71.37	$75.65	$90.29