Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $20.96 / $20.96 / $20.96	Facility		$20.96	$20.96	$20.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.63 / $20.96 / $30.24	Professional		$16.63	$20.96	$30.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $36.10 / $36.10 / $59.57	Facility		$36.10	$36.10	$59.57
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.57 / $36.10 / $41.15	Professional		$33.57	$36.10	$41.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $36.10 / $77.25 / $77.25	Facility		$36.10	$77.25	$77.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $97.32 / $113.73 / $151.15	Facility		$97.32	$113.73	$151.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.73 / $52.50 / $68.31	Professional		$14.73	$52.50	$68.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $20.71 / $29.75 / $36.10	Facility		$20.71	$29.75	$36.10
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $24.85 / $36.10	Professional		$24.85	$24.85	$36.10
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.71 / $29.75 / $37.90	Facility		$20.71	$29.75	$37.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $16.64 / $20.42 / $84.60	Professional		$16.64	$20.42	$84.60
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.96 / $58.40 / $85.00	Professional		$20.96	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $20.71 / $29.75 / $36.10	Facility		$20.71	$29.75	$36.10
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $24.85 / $36.10	Professional		$24.85	$24.85	$36.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $54.15 / $95.00	Professional		$36.10	$54.15	$95.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $70.50 / $73.28 / $168.95	Facility		$70.50	$73.28	$168.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.73 / $158.63 / $302.14	Professional		$14.73	$158.63	$302.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $36.10 / $36.10	Professional		$36.10	$36.10	$36.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $36.10 / $36.10 / $36.10	Professional		$36.10	$36.10	$36.10
United Facility/Professional Professional Modifier Low / Median / High Price $15.03 / $18.01 / $30.02	Professional		$15.03	$18.01	$30.02