Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.86 / $37.86 / $37.86	Facility		$37.86	$37.86	$37.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.84 / $37.86 / $68.06	Professional		$35.84	$37.86	$68.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.06 / $82.58 / $136.63	Facility		$75.06	$82.58	$136.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.56 / $69.81 / $92.33	Professional		$67.56	$69.81	$92.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.00 / $160.65 / $160.65	Facility		$54.00	$160.65	$160.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.91 / $165.31 / $313.50	Facility		$41.91	$165.31	$313.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.59 / $108.75 / $142.08	Professional		$30.59	$108.75	$142.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.60 / $56.81 / $86.33	Facility		$21.60	$56.81	$86.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $73.27 / $90.08	Professional		$42.98	$73.27	$90.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.39 / $75.06 / $349.60	Facility		$37.39	$75.06	$349.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.78 / $39.32 / $81.73	Professional		$32.78	$39.32	$81.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $14.87 / $58.40 / $85.00	Professional		$14.87	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.60 / $56.81 / $86.33	Facility		$21.60	$56.81	$86.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $42.98 / $73.27 / $90.08	Professional		$42.98	$73.27	$90.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $115.52 / $200.74	Professional		$75.06	$115.52	$200.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $41.91 / $146.62 / $349.60	Facility		$41.91	$146.62	$349.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.59 / $41.91 / $378.23	Professional		$30.59	$41.91	$378.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $75.06 / $75.06	Professional		$75.06	$75.06	$75.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.06 / $75.06 / $75.06	Professional		$75.06	$75.06	$75.06
United Facility/Professional Professional Modifier Low / Median / High Price $27.89 / $38.67 / $66.56	Professional		$27.89	$38.67	$66.56