Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.20 / $70.20 / $70.20	Facility		$70.20	$70.20	$70.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.95 / $63.50 / $84.36	Professional		$44.95	$63.50	$84.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.70 / $170.53 / $170.53	Facility		$93.70	$170.53	$170.53
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.14 / $93.70 / $126.49	Professional		$87.14	$93.70	$126.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.29 / $66.08 / $229.60	Facility		$10.29	$66.08	$229.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.78 / $60.78 / $252.31	Facility		$60.78	$60.78	$252.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.66 / $109.50 / $136.88	Professional		$51.66	$109.50	$136.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.43 / $112.50 / $164.51	Facility		$45.43	$112.50	$164.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $95.02 / $95.02 / $171.66	Professional		$95.02	$95.02	$171.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.43 / $149.63 / $435.85	Facility		$45.43	$149.63	$435.85
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.93 / $77.17 / $126.09	Professional		$51.93	$77.17	$126.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.35 / $58.40 / $73.92	Professional		$44.35	$58.40	$73.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $45.43 / $112.50 / $164.51	Facility		$45.43	$112.50	$164.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $95.02 / $95.02 / $171.66	Professional		$95.02	$95.02	$171.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.37 / $18.93 / $24.58	Professional		$12.37	$18.93	$24.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $182.00 / $435.85	Facility		$65.00	$182.00	$435.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.66 / $60.78 / $75.70	Professional		$51.66	$60.78	$75.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.34 / $121.34 / $121.34	Professional		$121.34	$121.34	$121.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.34 / $121.34 / $121.34	Professional		$121.34	$121.34	$121.34
United Facility/Professional Professional Modifier Low / Median / High Price $39.60 / $68.39 / $124.81	Professional		$39.60	$68.39	$124.81