Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $77.48 / $151.86 / $34,555.05	Facility		$77.48	$151.86	$34,555.05
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $77.48 / $96.26	Professional		$75.22	$77.48	$96.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.03 / $139.16 / $167.74	Facility		$94.03	$139.16	$167.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $75.22 / $112.83	Professional		$75.22	$75.22	$112.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.22 / $106.30 / $137.87	Facility		$75.22	$106.30	$137.87
CareSource Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $75.93 / $174.40	Professional		$75.22	$75.93	$174.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.22 / $103.49 / $215.14	Facility		$75.22	$103.49	$215.14
Cigna Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $88.70 / $155.51	Professional		$75.22	$88.70	$155.51
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $75.22 / $77.48 / $87.77	Facility		$75.22	$77.48	$87.77
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $113.90 / $150.44 / $150.44	Professional		$113.90	$150.44	$150.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $75.93 / $77.45 / $87.77	Facility		$75.93	$77.45	$87.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $75.93 / $84.53 / $359.03	Professional		$75.93	$84.53	$359.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $75.22 / $77.48 / $87.77	Facility		$75.22	$77.48	$87.77
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $113.90 / $150.44 / $150.44	Professional		$113.90	$150.44	$150.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $101.86 / $260.70	Professional		$75.22	$101.86	$260.70
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.22 / $95.83 / $462.80	Facility		$75.22	$95.83	$462.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $141.16 / $359.03	Professional		$75.22	$141.16	$359.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.61 / $105.61 / $119.25	Professional		$105.61	$105.61	$119.25
United Facility/Professional Professional Modifier Low / Median / High Price $75.22 / $79.73 / $110.65	Professional		$75.22	$79.73	$110.65