Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.18 / $61.18 / $61.18	Facility		$61.18	$61.18	$61.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.01 / $61.18 / $240.85	Professional		$58.01	$61.18	$240.85
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.49 / $83.49 / $137.76	Facility		$83.49	$83.49	$137.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.65 / $77.65 / $91.83	Professional		$77.65	$77.65	$91.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.14 / $178.67 / $178.67	Facility		$75.14	$178.67	$178.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $224.38 / $262.20 / $402.23	Facility		$224.38	$262.20	$402.23
Cigna Facility/Professional Professional Modifier Low / Median / High Price $0.09 / $120.94 / $158.00	Professional		$0.09	$120.94	$158.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $58.01 / $83.49 / $87.66	Facility		$58.01	$83.49	$87.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $29.93 / $29.93 / $29.93	Professional		$29.93	$29.93	$29.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.18 / $83.49 / $390.73	Facility		$61.18	$83.49	$390.73
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.65 / $94.40 / $253.50	Professional		$41.65	$94.40	$253.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.00 / $90.00	Professional		$65.00	$65.00	$90.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $58.01 / $83.49 / $87.66	Facility		$58.01	$83.49	$87.66
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $29.93 / $29.93 / $29.93	Professional		$29.93	$29.93	$29.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.49 / $126.24 / $249.92	Professional		$83.49	$126.24	$249.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $163.06 / $169.48 / $390.73	Facility		$163.06	$169.48	$390.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $0.09 / $0.09 / $0.09	Professional		$0.09	$0.09	$0.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $83.49 / $83.49 / $83.49	Professional		$83.49	$83.49	$83.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $83.49 / $83.49 / $83.49	Professional		$83.49	$83.49	$83.49
United Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $83.29 / $253.50	Professional		$32.61	$83.29	$253.50