Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $95.96 / $95.96 / $95.96	Facility		$95.96	$95.96	$95.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.49 / $86.36 / $115.18	Professional		$61.49	$86.36	$115.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $143.90 / $261.89 / $261.89	Facility		$143.90	$261.89	$261.89
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.83 / $133.94 / $194.26	Professional		$133.83	$133.94	$194.26
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.35 / $77.72 / $308.20	Facility		$10.35	$77.72	$308.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $62.10 / $387.48	Facility		$62.10	$62.10	$387.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $166.88 / $208.59	Professional		$62.10	$166.88	$208.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.01 / $95.96 / $172.73	Facility		$40.01	$95.96	$172.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $71.14 / $71.14 / $172.82	Professional		$71.14	$71.14	$172.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.01 / $172.82 / $640.17	Facility		$40.01	$172.82	$640.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.31 / $72.31 / $162.79	Professional		$57.31	$72.31	$162.79
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $65.00	Professional		$50.00	$58.40	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $40.01 / $95.96 / $172.73	Facility		$40.01	$95.96	$172.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $71.14 / $71.14 / $172.82	Professional		$71.14	$71.14	$172.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $18.98 / $32.34 / $41.99	Professional		$18.98	$32.34	$41.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $281.27 / $640.17	Facility		$62.10	$281.27	$640.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.10 / $62.10 / $102.38	Professional		$62.10	$62.10	$102.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $144.02 / $144.02 / $144.02	Professional		$144.02	$144.02	$144.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $144.02 / $144.02 / $144.02	Professional		$144.02	$144.02	$144.02
United Facility/Professional Professional Modifier Low / Median / High Price $48.53 / $71.84 / $154.94	Professional		$48.53	$71.84	$154.94