Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.34 / $68.34 / $68.34	Facility		$68.34	$68.34	$68.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.34 / $81.37 / $226.20	Professional		$68.34	$81.37	$226.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $135.49 / $149.04 / $246.59	Facility		$135.49	$149.04	$246.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $126.01 / $126.01 / $166.65	Professional		$126.01	$126.01	$166.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.47 / $289.95 / $289.95	Facility		$97.47	$289.95	$289.95
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.88 / $280.49 / $565.41	Facility		$86.88	$280.49	$565.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.42 / $196.41 / $256.41	Professional		$63.42	$196.41	$256.41
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $43.64 / $101.84 / $155.81	Facility		$43.64	$101.84	$155.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $77.58 / $135.49 / $180.65	Professional		$77.58	$135.49	$180.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $68.34 / $135.49 / $722.40	Facility		$68.34	$135.49	$722.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $61.37 / $78.86 / $152.96	Professional		$61.37	$78.86	$152.96
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $43.64 / $102.53 / $155.81	Facility		$43.64	$102.53	$155.81
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $77.58 / $135.49 / $180.65	Professional		$77.58	$135.49	$180.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.49 / $208.51 / $405.49	Professional		$135.49	$208.51	$405.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $86.88 / $264.62 / $722.40	Facility		$86.88	$264.62	$722.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.42 / $86.88 / $1,283.27	Professional		$63.42	$86.88	$1,283.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $135.49 / $135.49 / $135.49	Professional		$135.49	$135.49	$135.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $108.19 / $135.49 / $135.49	Professional		$108.19	$135.49	$135.49
United Facility/Professional Professional Modifier Low / Median / High Price $53.98 / $67.59 / $126.61	Professional		$53.98	$67.59	$126.61