Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.38 / $60.38 / $60.38	Facility		$60.38	$60.38	$60.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.19 / $60.38 / $108.61	Professional		$57.19	$60.38	$108.61
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $119.70 / $131.66 / $217.85	Facility		$119.70	$131.66	$217.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.52 / $111.32 / $147.22	Professional		$103.52	$111.32	$147.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $86.11 / $256.16 / $256.16	Facility		$86.11	$256.16	$256.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.33 / $247.64 / $499.64	Facility		$84.33	$247.64	$499.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.56 / $173.44 / $226.54	Professional		$61.56	$173.44	$226.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.70 / $90.57 / $137.66	Facility		$36.70	$90.57	$137.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $68.52 / $119.70 / $143.63	Professional		$68.52	$119.70	$143.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.38 / $119.70 / $593.85	Facility		$60.38	$119.70	$593.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.56 / $67.62 / $130.34	Professional		$52.56	$67.62	$130.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.07 / $55.00 / $85.00	Professional		$41.07	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.70 / $90.57 / $137.66	Facility		$36.70	$90.57	$137.66
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $68.52 / $119.70 / $143.63	Professional		$68.52	$119.70	$143.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $184.21 / $341.26	Professional		$119.70	$184.21	$341.26
Quartz Facility/Professional Facility Modifier Low / Median / High Price $84.33 / $233.78 / $593.85	Facility		$84.33	$233.78	$593.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.56 / $84.33 / $667.95	Professional		$61.56	$84.33	$667.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $119.70 / $119.70	Professional		$119.70	$119.70	$119.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $119.70 / $119.70 / $119.70	Professional		$119.70	$119.70	$119.70
United Facility/Professional Professional Modifier Low / Median / High Price $47.68 / $66.33 / $106.49	Professional		$47.68	$66.33	$106.49