Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $90.62 / $90.62 / $90.62	Facility		$90.62	$90.62	$90.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $90.62 / $96.77	Professional		$87.98	$90.62	$96.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $131.97	Professional		$87.98	$87.98	$131.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $120.45 / $140.77 / $140.77	Facility		$120.45	$140.77	$140.77
Cigna Facility/Professional Facility Modifier Low / Median / High Price $182.50 / $333.87 / $473.20	Facility		$182.50	$333.87	$473.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $120.89 / $260.63	Professional		$87.98	$120.89	$260.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $80.48 / $90.62 / $151.50	Facility		$80.48	$90.62	$151.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $80.48 / $82.90 / $149.22	Facility		$80.48	$82.90	$149.22
Medica Facility/Professional Professional Modifier Low / Median / High Price $80.48 / $80.48 / $169.01	Professional		$80.48	$80.48	$169.01
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.00 / $85.00	Professional		$50.00	$60.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $80.48 / $90.62 / $151.50	Facility		$80.48	$90.62	$151.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $126.36 / $323.39	Professional		$87.98	$126.36	$323.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $94.93 / $147.94 / $530.54	Facility		$94.93	$147.94	$530.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $186.53 / $558.10	Professional		$87.98	$186.53	$558.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $123.52 / $123.52 / $123.52	Professional		$123.52	$123.52	$123.52
United Facility/Professional Professional Modifier Low / Median / High Price $87.98 / $87.98 / $114.37	Professional		$87.98	$87.98	$114.37