Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.39 / $27.39 / $27.39	Facility		$27.39	$27.39	$27.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.49 / $28.31 / $35.92	Professional		$26.49	$28.31	$35.92
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.18 / $47.18 / $77.84	Facility		$47.18	$47.18	$77.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.88 / $47.18 / $53.78	Professional		$43.88	$47.18	$53.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.18 / $100.97 / $100.97	Facility		$47.18	$100.97	$100.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.06 / $148.47 / $197.34	Facility		$127.06	$148.47	$197.34
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.25 / $68.44 / $89.29	Professional		$19.25	$68.44	$89.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.07 / $38.88 / $49.30	Facility		$27.07	$38.88	$49.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $47.18 / $47.18 / $50.50	Professional		$47.18	$47.18	$50.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.39 / $38.88 / $60.59	Facility		$27.39	$38.88	$60.59
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.77 / $26.68 / $171.23	Professional		$21.77	$26.68	$171.23
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.42 / $58.40 / $85.00	Professional		$27.42	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.07 / $38.88 / $49.30	Facility		$27.07	$38.88	$49.30
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $47.18 / $47.18 / $50.50	Professional		$47.18	$47.18	$50.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.18 / $70.77 / $124.00	Professional		$47.18	$70.77	$124.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $92.14 / $95.78 / $263.91	Facility		$92.14	$95.78	$263.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.25 / $207.32 / $609.54	Professional		$19.25	$207.32	$609.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.18 / $47.18 / $47.18	Professional		$47.18	$47.18	$47.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.18 / $47.18 / $47.18	Professional		$47.18	$47.18	$47.18
United Facility/Professional Professional Modifier Low / Median / High Price $15.69 / $23.54 / $43.70	Professional		$15.69	$23.54	$43.70