Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.77 / $68.77 / $68.77	Facility		$68.77	$68.77	$68.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.06 / $60.62 / $80.81	Professional		$43.06	$60.62	$80.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.50 / $170.17 / $170.17	Facility		$93.50	$170.17	$170.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.98 / $86.96 / $121.93	Professional		$81.98	$86.96	$121.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.69 / $65.91 / $216.91	Facility		$9.69	$65.91	$216.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.80 / $60.80 / $242.40	Facility		$60.80	$60.80	$242.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.80 / $105.00 / $131.25	Professional		$60.80	$105.00	$131.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $59.00 / $106.27 / $155.33	Facility		$59.00	$106.27	$155.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $89.74 / $89.74 / $162.08	Professional		$89.74	$89.74	$162.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.00 / $155.33 / $436.04	Facility		$59.00	$155.33	$436.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.13 / $72.86 / $125.46	Professional		$51.13	$72.86	$125.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $63.91 / $90.00	Professional		$50.00	$63.91	$90.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $59.00 / $106.27 / $155.33	Facility		$59.00	$106.27	$155.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $89.74 / $89.74 / $162.08	Professional		$89.74	$89.74	$162.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.34 / $19.72 / $25.61	Professional		$12.34	$19.72	$25.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $60.80 / $181.56 / $436.04	Facility		$60.80	$181.56	$436.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.80 / $60.80 / $81.41	Professional		$60.80	$60.80	$81.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.56 / $117.56 / $117.56	Professional		$117.56	$117.56	$117.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.56 / $117.56 / $117.56	Professional		$117.56	$117.56	$117.56
United Facility/Professional Professional Modifier Low / Median / High Price $45.05 / $70.54 / $123.48	Professional		$45.05	$70.54	$123.48