Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $126.14 / $126.14 / $126.14	Facility		$126.14	$126.14	$126.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $76.05 / $110.31 / $142.74	Professional		$76.05	$110.31	$142.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $181.30 / $329.97 / $329.97	Facility		$181.30	$329.97	$329.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $143.33 / $168.61 / $222.99	Professional		$143.33	$168.61	$222.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $12.78 / $15.74 / $46.82	Facility		$12.78	$15.74	$46.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.17 / $64.17 / $468.58	Facility		$64.17	$64.17	$468.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.54 / $202.50 / $253.13	Professional		$54.54	$202.50	$253.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.16 / $126.14 / $189.21	Facility		$25.16	$126.14	$189.21
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $26.26 / $145.36	Professional		$26.26	$26.26	$145.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $22.01 / $181.53 / $821.30	Facility		$22.01	$181.53	$821.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.63 / $117.25 / $181.70	Professional		$68.63	$117.25	$181.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $99.06	Professional		$50.00	$65.00	$99.06
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.16 / $126.14 / $189.21	Facility		$25.16	$126.14	$189.21
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $26.26 / $26.26 / $145.36	Professional		$26.26	$26.26	$145.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $20.23 / $36.28 / $47.11	Professional		$20.23	$36.28	$47.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.17 / $279.06 / $821.30	Facility		$64.17	$279.06	$821.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.43 / $64.17 / $64.17	Professional		$13.43	$64.17	$64.17
United Facility/Professional Professional Modifier Low / Median / High Price $62.20 / $100.50 / $181.70	Professional		$62.20	$100.50	$181.70