Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.70 / $70.88 / $105.37	Facility		$56.70	$70.88	$105.37
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.50 / $39.31 / $56.70	Professional		$32.50	$39.31	$56.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $101.59 / $122.85 / $129.94	Facility		$101.59	$122.85	$129.94
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $18.89 / $47.25 / $202.38	Professional		$18.89	$47.25	$202.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.25 / $70.17 / $120.02	Facility		$47.25	$70.17	$120.02
CareSource Facility/Professional Professional Modifier Low / Median / High Price $47.25 / $49.61 / $61.07	Professional		$47.25	$49.61	$61.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $129.76 / $151.63 / $232.61	Facility		$129.76	$151.63	$232.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.10 / $127.24 / $144.59	Professional		$54.10	$127.24	$144.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.38 / $56.70 / $165.38	Facility		$36.38	$56.70	$165.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.53 / $56.70 / $165.38	Facility		$42.53	$56.70	$165.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $23.63 / $28.35 / $145.71	Professional		$23.63	$28.35	$145.71
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.25 / $65.00 / $85.00	Professional		$47.25	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.38 / $56.70 / $165.38	Facility		$36.38	$56.70	$165.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.67 / $115.16 / $157.94	Professional		$89.67	$115.16	$157.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $276.58 / $276.58 / $276.58	Facility		$276.58	$276.58	$276.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $68.51 / $236.25 / $236.25	Professional		$68.51	$236.25	$236.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $100.62 / $100.62 / $100.62	Professional		$100.62	$100.62	$100.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $137.32 / $257.99 / $257.99	Professional		$137.32	$257.99	$257.99
United Facility/Professional Facility Modifier Low / Median / High Price $56.70 / $56.70 / $56.70	Facility		$56.70	$56.70	$56.70
United Facility/Professional Professional Modifier Low / Median / High Price $23.63 / $28.35 / $87.95	Professional		$23.63	$28.35	$87.95