Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $89.96 / $89.96 / $89.96	Facility		$89.96	$89.96	$89.96
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.31 / $80.65 / $105.70	Professional		$56.31	$80.65	$105.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $134.10 / $244.06 / $244.06	Facility		$134.10	$244.06	$244.06
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.58 / $124.71 / $180.84	Professional		$124.58	$124.71	$180.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.65 / $96.38 / $286.67	Facility		$9.65	$96.38	$286.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.42 / $96.42 / $358.65	Facility		$96.42	$96.42	$358.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $96.42 / $154.50 / $193.13	Professional		$96.42	$154.50	$193.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.97 / $114.59 / $160.75	Facility		$42.97	$114.59	$160.75
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $76.39 / $76.39 / $160.75	Professional		$76.39	$76.39	$160.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.97 / $160.75 / $671.07	Facility		$42.97	$160.75	$671.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.41 / $76.93 / $161.40	Professional		$56.41	$76.93	$161.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.41 / $58.40 / $80.69	Professional		$48.41	$58.40	$80.69
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $42.97 / $114.59 / $160.75	Facility		$42.97	$114.59	$160.75
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $76.39 / $76.39 / $160.75	Professional		$76.39	$76.39	$160.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.70 / $32.34 / $41.99	Professional		$17.70	$32.34	$41.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $96.42 / $261.64 / $671.07	Facility		$96.42	$261.64	$671.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $96.42 / $96.42 / $106.80	Professional		$96.42	$96.42	$106.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $133.96 / $133.96 / $133.96	Professional		$133.96	$133.96	$133.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $133.96 / $133.96 / $133.96	Professional		$133.96	$133.96	$133.96
United Facility/Professional Professional Modifier Low / Median / High Price $53.16 / $66.83 / $133.96	Professional		$53.16	$66.83	$133.96