Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.22 / $37.22 / $37.22	Facility		$37.22	$37.22	$37.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.54 / $37.22 / $61.81	Professional		$30.54	$37.22	$61.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.80 / $81.18 / $134.32	Facility		$73.80	$81.18	$134.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.42 / $68.63 / $90.77	Professional		$66.42	$68.63	$90.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.09 / $157.93 / $157.93	Facility		$53.09	$157.93	$157.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.81 / $152.91 / $307.89	Facility		$45.81	$152.91	$307.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.44 / $106.88 / $139.68	Professional		$33.44	$106.88	$139.68
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.61 / $55.85 / $84.87	Facility		$23.61	$55.85	$84.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $42.25 / $73.80 / $97.76	Professional		$42.25	$73.80	$97.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.22 / $73.80 / $392.56	Facility		$37.22	$73.80	$392.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.29 / $49.30 / $83.30	Professional		$34.29	$49.30	$83.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.44 / $58.40 / $85.00	Professional		$35.44	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $23.61 / $56.96 / $84.87	Facility		$23.61	$56.96	$84.87
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $42.25 / $73.80 / $97.76	Professional		$42.25	$73.80	$97.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.80 / $113.56 / $219.81	Professional		$73.80	$113.56	$219.81
Quartz Facility/Professional Facility Modifier Low / Median / High Price $45.81 / $144.13 / $392.56	Facility		$45.81	$144.13	$392.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.44 / $45.81 / $576.36	Professional		$33.44	$45.81	$576.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $73.80 / $73.80 / $73.80	Professional		$73.80	$73.80	$73.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $73.80 / $73.80 / $73.80	Professional		$73.80	$73.80	$73.80
United Facility/Professional Professional Modifier Low / Median / High Price $29.40 / $48.77 / $73.80	Professional		$29.40	$48.77	$73.80