Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $100.66 / $100.66 / $100.66	Facility		$100.66	$100.66	$100.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.70 / $91.67 / $113.94	Professional		$60.70	$91.67	$113.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $131.30 / $144.43 / $238.97	Facility		$131.30	$144.43	$238.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.19 / $122.11 / $164.12	Professional		$99.19	$122.11	$164.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.26 / $28.10 / $28.10	Facility		$9.26	$28.10	$28.10
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.29 / $409.60 / $646.15	Facility		$80.29	$409.60	$646.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $98.98 / $153.75 / $192.19	Professional		$98.98	$153.75	$192.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $12.10 / $68.04 / $150.99	Facility		$12.10	$68.04	$150.99
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $15.76 / $96.20 / $96.20	Professional		$15.76	$96.20	$96.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $13.13 / $138.26 / $637.21	Facility		$13.13	$138.26	$637.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.88 / $73.43 / $130.53	Professional		$47.88	$73.43	$130.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $0.53 / $55.00 / $90.70	Professional		$0.53	$55.00	$90.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $12.10 / $100.66 / $150.99	Facility		$12.10	$100.66	$150.99
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $15.76 / $96.20 / $96.20	Professional		$15.76	$96.20	$96.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.66 / $28.40 / $36.86	Professional		$14.66	$28.40	$36.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $80.29 / $229.36 / $637.21	Facility		$80.29	$229.36	$637.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.52 / $10.52 / $114.91	Professional		$10.52	$10.52	$114.91
United Facility/Professional Professional Modifier Low / Median / High Price $47.88 / $67.34 / $126.14	Professional		$47.88	$67.34	$126.14