Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.59 / $72.59 / $72.59	Facility		$72.59	$72.59	$72.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.03 / $63.28 / $82.64	Professional		$44.03	$63.28	$82.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $103.30 / $188.01 / $188.01	Facility		$103.30	$188.01	$188.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.03 / $96.07 / $139.40	Professional		$96.03	$96.07	$139.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.30 / $69.64 / $220.98	Facility		$9.30	$69.64	$220.98
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.95 / $65.95 / $263.13	Facility		$65.95	$65.95	$263.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $114.38 / $142.97	Professional		$65.95	$114.38	$142.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.99 / $103.22 / $148.38	Facility		$40.99	$103.22	$148.38
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $85.73 / $85.73 / $154.84	Professional		$85.73	$85.73	$154.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.99 / $152.40 / $473.38	Facility		$40.99	$152.40	$473.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.41 / $71.33 / $130.99	Professional		$51.41	$71.33	$130.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.68 / $58.40 / $82.80	Professional		$49.68	$58.40	$82.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $40.99 / $108.90 / $148.38	Facility		$40.99	$108.90	$148.38
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $85.73 / $85.73 / $154.84	Professional		$85.73	$85.73	$154.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.64 / $22.09 / $28.68	Professional		$13.64	$22.09	$28.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.95 / $200.50 / $473.38	Facility		$65.95	$200.50	$473.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.95 / $65.95 / $87.12	Professional		$65.95	$65.95	$87.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $118.88 / $118.88 / $118.88	Professional		$118.88	$118.88	$118.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $118.88 / $118.88 / $118.88	Professional		$118.88	$118.88	$118.88
United Facility/Professional Professional Modifier Low / Median / High Price $49.87 / $71.33 / $119.52	Professional		$49.87	$71.33	$119.52