Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $127.52 / $127.52 / $127.52	Facility		$127.52	$127.52	$127.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $127.52 / $136.18	Professional		$123.80	$127.52	$136.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $203.03	Professional		$123.80	$123.80	$203.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $169.49 / $196.84 / $198.08	Facility		$169.49	$196.84	$198.08
Cigna Facility/Professional Facility Modifier Low / Median / High Price $173.44 / $317.27 / $449.70	Facility		$173.44	$317.27	$449.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $128.47 / $166.16	Professional		$123.80	$128.47	$166.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $123.80 / $127.52 / $213.34	Facility		$123.80	$127.52	$213.34
Medica Facility/Professional Facility Modifier Low / Median / High Price $126.06 / $129.85 / $233.73	Facility		$126.06	$129.85	$233.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $126.06 / $126.06 / $309.66	Professional		$126.06	$126.06	$309.66
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $313.37	Professional		$50.00	$70.00	$313.37
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $123.80 / $127.52 / $213.34	Facility		$123.80	$127.52	$213.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $134.31 / $315.27	Professional		$123.80	$134.31	$315.27
Quartz Facility/Professional Facility Modifier Low / Median / High Price $128.43 / $263.50 / $562.96	Facility		$128.43	$263.50	$562.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $243.00 / $3,125.88	Professional		$123.80	$243.00	$3,125.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $173.82 / $173.82 / $173.82	Professional		$173.82	$173.82	$173.82
United Facility/Professional Professional Modifier Low / Median / High Price $123.80 / $123.80 / $160.94	Professional		$123.80	$123.80	$160.94