Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.72 / $67.72 / $67.72	Facility		$67.72	$67.72	$67.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.30 / $62.71 / $79.40	Professional		$42.30	$62.71	$79.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $98.80 / $179.82 / $179.82	Facility		$98.80	$179.82	$179.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.52 / $91.88 / $123.50	Professional		$76.52	$91.88	$123.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.96 / $69.66 / $241.86	Facility		$6.96	$69.66	$241.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.39 / $66.39 / $266.73	Facility		$66.39	$66.39	$266.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.43 / $115.88 / $144.84	Professional		$56.43	$115.88	$144.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.40 / $101.58 / $129.97	Facility		$36.40	$101.58	$129.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $75.81 / $75.81 / $135.62	Professional		$75.81	$75.81	$135.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.40 / $135.62 / $476.05	Facility		$36.40	$135.62	$476.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.54 / $60.82 / $116.99	Professional		$44.54	$60.82	$116.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.01 / $58.40 / $81.69	Professional		$49.01	$58.40	$81.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.40 / $101.58 / $129.97	Facility		$36.40	$101.58	$129.97
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $75.81 / $75.81 / $135.62	Professional		$75.81	$75.81	$135.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.04 / $19.72 / $25.61	Professional		$13.04	$19.72	$25.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $66.39 / $191.86 / $476.05	Facility		$66.39	$191.86	$476.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.43 / $66.39 / $87.14	Professional		$56.43	$66.39	$87.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $108.90 / $108.90 / $108.90	Professional		$108.90	$108.90	$108.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $108.90 / $108.90 / $108.90	Professional		$108.90	$108.90	$108.90
United Facility/Professional Professional Modifier Low / Median / High Price $38.21 / $53.87 / $111.36	Professional		$38.21	$53.87	$111.36