Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.59 / $51.59 / $51.59	Facility		$51.59	$51.59	$51.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $27.60 / $51.59 / $71.56	Professional		$27.60	$51.59	$71.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $88.85 / $97.74 / $161.71	Facility		$88.85	$97.74	$161.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $79.95 / $82.63 / $109.28	Professional		$79.95	$82.63	$109.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.91 / $106.62 / $190.14	Facility		$63.91	$106.62	$190.14
CareSource Facility/Professional Professional Modifier Low / Median / High Price $88.85 / $93.29 / $124.39	Professional		$88.85	$93.29	$124.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.47 / $265.00 / $370.88	Facility		$59.47	$265.00	$370.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $130.97 / $168.16	Professional		$43.41	$130.97	$168.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.75 / $74.42 / $102.18	Facility		$25.75	$74.42	$102.18
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $50.86 / $88.85 / $106.62	Professional		$50.86	$88.85	$106.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.58 / $92.86 / $415.82	Facility		$44.58	$92.86	$415.82
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.30 / $59.36 / $104.77	Professional		$41.30	$59.36	$104.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.29 / $58.40 / $85.00	Professional		$46.29	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.75 / $77.39 / $102.18	Facility		$25.75	$77.39	$102.18
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $50.86 / $88.85 / $106.62	Professional		$50.86	$88.85	$106.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.85 / $136.72 / $238.88	Professional		$88.85	$136.72	$238.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $59.47 / $173.54 / $415.82	Facility		$59.47	$173.54	$415.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $59.47 / $442.47	Professional		$43.41	$59.47	$442.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $88.85 / $88.85 / $88.85	Professional		$88.85	$88.85	$88.85
Security Health Facility/Professional Professional Modifier Low / Median / High Price $88.85 / $88.85 / $88.85	Professional		$88.85	$88.85	$88.85
United Facility/Professional Professional Modifier Low / Median / High Price $35.39 / $57.23 / $84.95	Professional		$35.39	$57.23	$84.95