Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.18 / $49.18 / $49.18	Facility		$49.18	$49.18	$49.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.39 / $49.18 / $89.13	Professional		$47.39	$49.18	$89.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.48 / $107.23 / $177.41	Facility		$97.48	$107.23	$177.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.66 / $90.66 / $119.90	Professional		$90.66	$90.66	$119.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.13 / $208.61 / $208.61	Facility		$70.13	$208.61	$208.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.72 / $201.70 / $407.27	Facility		$62.72	$201.70	$407.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.79 / $141.09 / $184.50	Professional		$45.79	$141.09	$184.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.71 / $73.77 / $112.10	Facility		$29.71	$73.77	$112.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $55.82 / $97.48 / $123.01	Professional		$55.82	$97.48	$123.01
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.18 / $97.48 / $490.51	Facility		$49.18	$97.48	$490.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $53.70 / $110.06	Professional		$43.34	$53.70	$110.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.64 / $55.00 / $85.00	Professional		$36.64	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.71 / $73.77 / $112.10	Facility		$29.71	$73.77	$112.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $55.82 / $97.48 / $123.01	Professional		$55.82	$97.48	$123.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $97.48 / $150.03 / $276.02	Professional		$97.48	$150.03	$276.02
Quartz Facility/Professional Facility Modifier Low / Median / High Price $62.72 / $190.40 / $490.51	Facility		$62.72	$190.40	$490.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.79 / $62.72 / $793.53	Professional		$45.79	$62.72	$793.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.48 / $97.48 / $97.48	Professional		$97.48	$97.48	$97.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $97.48 / $97.48	Professional		$77.84	$97.48	$97.48
United Facility/Professional Facility Modifier Low / Median / High Price $147.61 / $147.61 / $147.61	Facility		$147.61	$147.61	$147.61
United Facility/Professional Professional Modifier Low / Median / High Price $36.04 / $48.64 / $93.22	Professional		$36.04	$48.64	$93.22