Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.80 / $62.80 / $62.80	Facility		$62.80	$62.80	$62.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.80 / $68.48 / $87.13	Professional		$62.80	$68.48	$87.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $108.17 / $118.99 / $196.87	Facility		$108.17	$118.99	$196.87
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.35 / $100.60 / $133.04	Professional		$97.35	$100.60	$133.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.81 / $231.48 / $231.48	Facility		$77.81	$231.48	$231.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $291.06 / $340.13 / $521.77	Facility		$291.06	$340.13	$521.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.13 / $180.15 / $204.71	Professional		$44.13	$180.15	$204.71
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.61 / $90.60 / $124.40	Facility		$29.61	$90.60	$124.40
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.92 / $108.17 / $129.80	Professional		$61.92	$108.17	$129.80
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.63 / $113.04 / $508.15	Facility		$52.63	$113.04	$508.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.86 / $54.56 / $125.39	Professional		$45.86	$54.56	$125.39
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 $29.61 / $94.20 / $124.40	Facility		$29.61	$94.20	$124.40
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $61.92 / $108.17 / $129.80	Professional		$61.92	$108.17	$129.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $108.17 / $166.47 / $275.01	Professional		$108.17	$166.47	$275.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $211.26 / $211.26 / $508.15	Facility		$211.26	$211.26	$508.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.13 / $134.90 / $538.69	Professional		$44.13	$134.90	$538.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $108.17 / $108.17 / $108.17	Professional		$108.17	$108.17	$108.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $108.17 / $108.17 / $108.17	Professional		$108.17	$108.17	$108.17
United Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $53.96 / $103.42	Professional		$35.97	$53.96	$103.42