Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.62 / $64.62 / $64.62	Facility		$64.62	$64.62	$64.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.72 / $55.39 / $73.84	Professional		$42.72	$55.39	$73.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $88.59 / $97.45 / $161.22	Facility		$88.59	$97.45	$161.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.44 / $82.39 / $100.99	Professional		$66.44	$82.39	$100.99
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.61 / $189.58 / $189.58	Facility		$59.61	$189.58	$189.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $281.60 / $384.88	Facility		$65.00	$281.60	$384.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.25 / $134.53 / $166.69	Professional		$55.25	$134.53	$166.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $70.87 / $101.88	Facility		$48.00	$70.87	$101.88
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $106.31 / $106.31 / $106.31	Professional		$106.31	$106.31	$106.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.93 / $88.59 / $425.46	Facility		$49.93	$88.59	$425.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.56 / $55.52 / $141.18	Professional		$45.56	$55.52	$141.18
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $66.01	Professional		$50.00	$58.40	$66.01
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $73.84 / $101.88	Facility		$48.00	$73.84	$101.88
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $106.31 / $106.31 / $106.31	Professional		$106.31	$106.31	$106.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.59 / $162.90 / $250.93	Professional		$88.59	$162.90	$250.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $172.02 / $425.46	Facility		$65.00	$172.02	$425.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.25 / $103.34 / $482.72	Professional		$55.25	$103.34	$482.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $108.60 / $108.60 / $108.60	Professional		$108.60	$108.60	$108.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $108.60 / $108.60 / $108.60	Professional		$108.60	$108.60	$108.60
United Facility/Professional Professional Modifier Low / Median / High Price $32.08 / $55.52 / $97.17	Professional		$32.08	$55.52	$97.17