Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $119.28 / $119.28 / $119.28	Facility		$119.28	$119.28	$119.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $92.51 / $119.28 / $198.04	Professional		$92.51	$119.28	$198.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $236.44 / $260.08 / $430.32	Facility		$236.44	$260.08	$430.32
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $212.79 / $219.89 / $290.82	Professional		$212.79	$219.89	$290.82
CareSource Facility/Professional Facility Modifier Low / Median / High Price $170.09 / $505.98 / $505.98	Facility		$170.09	$505.98	$505.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $138.76 / $488.74 / $986.69	Facility		$138.76	$488.74	$986.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.29 / $342.66 / $447.49	Professional		$101.29	$342.66	$447.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $178.92 / $271.91	Facility		$71.52	$178.92	$271.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $135.38 / $236.44 / $296.08	Professional		$135.38	$236.44	$296.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $119.28 / $236.44 / $1,184.51	Facility		$119.28	$236.44	$1,184.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $109.94 / $158.00 / $266.95	Professional		$109.94	$158.00	$266.95
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $149.86	Professional		$50.00	$70.00	$149.86
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $71.52 / $182.50 / $271.91	Facility		$71.52	$182.50	$271.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $135.38 / $236.44 / $296.08	Professional		$135.38	$236.44	$296.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $236.44 / $363.89 / $664.45	Professional		$236.44	$363.89	$664.45
Quartz Facility/Professional Facility Modifier Low / Median / High Price $138.76 / $461.80 / $1,184.51	Facility		$138.76	$461.80	$1,184.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.29 / $138.76 / $1,469.79	Professional		$101.29	$138.76	$1,469.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $236.44 / $236.44 / $236.44	Professional		$236.44	$236.44	$236.44
Security Health Facility/Professional Professional Modifier Low / Median / High Price $236.44 / $236.44 / $236.44	Professional		$236.44	$236.44	$236.44
United Facility/Professional Facility Modifier Low / Median / High Price $355.31 / $355.31 / $355.31	Facility		$355.31	$355.31	$355.31
United Facility/Professional Professional Modifier Low / Median / High Price $94.20 / $147.72 / $209.63	Professional		$94.20	$147.72	$209.63