Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.66 / $61.66 / $61.66	Facility		$61.66	$61.66	$61.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.66 / $67.62 / $86.02	Professional		$61.66	$67.62	$86.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.21 / $116.83 / $193.30	Facility		$106.21	$116.83	$193.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $73.83 / $98.78 / $130.63	Professional		$73.83	$98.78	$130.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.41 / $227.29 / $227.29	Facility		$76.41	$227.29	$227.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $285.66 / $333.81 / $512.07	Facility		$285.66	$333.81	$512.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.55 / $176.89 / $201.01	Professional		$45.55	$176.89	$201.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.56 / $88.53 / $122.14	Facility		$30.56	$88.53	$122.14
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $60.82 / $103.66 / $127.45	Professional		$60.82	$103.66	$127.45
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.91 / $110.99 / $456.25	Facility		$52.91	$110.99	$456.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.35 / $56.32 / $124.35	Professional		$47.35	$56.32	$124.35
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $30.56 / $92.49 / $122.14	Facility		$30.56	$92.49	$122.14
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $60.82 / $103.66 / $127.45	Professional		$60.82	$103.66	$127.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.21 / $163.44 / $284.05	Professional		$106.21	$163.44	$284.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $207.44 / $207.44 / $456.25	Facility		$207.44	$207.44	$456.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.55 / $132.47 / $535.65	Professional		$45.55	$132.47	$535.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $106.21 / $106.21 / $106.21	Professional		$106.21	$106.21	$106.21
Security Health Facility/Professional Professional Modifier Low / Median / High Price $106.21 / $106.21 / $106.21	Professional		$106.21	$106.21	$106.21
United Facility/Professional Professional Modifier Low / Median / High Price $39.46 / $52.99 / $101.56	Professional		$39.46	$52.99	$101.56