Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.58 / $27.58 / $27.58	Facility		$27.58	$27.58	$27.58
Aetna Facility/Professional Professional Modifier Low / Median / High Price $15.17 / $27.58 / $85.60	Professional		$15.17	$27.58	$85.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.51 / $47.51 / $78.39	Facility		$47.51	$47.51	$78.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.18 / $47.51 / $54.16	Professional		$44.18	$47.51	$54.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.51 / $101.67 / $101.67	Facility		$47.51	$101.67	$101.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.96 / $149.53 / $198.74	Facility		$127.96	$149.53	$198.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.38 / $68.91 / $89.93	Professional		$19.38	$68.91	$89.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.68 / $38.61 / $47.51	Facility		$26.68	$38.61	$47.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $26.46 / $26.46 / $47.51	Professional		$26.46	$26.46	$47.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.10 / $39.15 / $49.89	Facility		$27.10	$39.15	$49.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $21.91 / $26.46 / $94.78	Professional		$21.91	$26.46	$94.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $27.60 / $58.40 / $85.00	Professional		$27.60	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.68 / $39.15 / $47.51	Facility		$26.68	$39.15	$47.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $26.46 / $26.46 / $47.51	Professional		$26.46	$26.46	$47.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.51 / $71.27 / $125.00	Professional		$47.51	$71.27	$125.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $92.80 / $96.45 / $222.35	Facility		$92.80	$96.45	$222.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $19.38 / $208.80 / $319.80	Professional		$19.38	$208.80	$319.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.51 / $47.51 / $47.51	Professional		$47.51	$47.51	$47.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.31 / $47.51 / $47.51	Professional		$47.31	$47.51	$47.51
United Facility/Professional Professional Modifier Low / Median / High Price $16.79 / $23.70 / $39.50	Professional		$16.79	$23.70	$39.50