Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.32 / $92.32 / $92.32	Facility		$92.32	$92.32	$92.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.00 / $82.68 / $110.74	Professional		$59.00	$82.68	$110.74
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $125.60 / $228.59 / $228.59	Facility		$125.60	$228.59	$228.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.76 / $125.55 / $169.49	Professional		$116.76	$125.55	$169.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $13.04 / $88.51 / $290.93	Facility		$13.04	$88.51	$290.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.17 / $81.17 / $333.41	Facility		$81.17	$81.17	$333.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.17 / $144.38 / $180.47	Professional		$81.17	$144.38	$180.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $57.57 / $144.99 / $208.43	Facility		$57.57	$144.99	$208.43
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $120.41 / $120.41 / $217.49	Professional		$120.41	$120.41	$217.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.57 / $199.86 / $582.10	Facility		$57.57	$199.86	$582.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.06 / $97.78 / $165.76	Professional		$68.06	$97.78	$165.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $76.75 / $104.90	Professional		$55.00	$76.75	$104.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $57.57 / $142.57 / $208.43	Facility		$57.57	$142.57	$208.43
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $120.41 / $120.41 / $217.49	Professional		$120.41	$120.41	$217.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.57 / $24.45 / $31.75	Professional		$16.57	$24.45	$31.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $81.17 / $243.78 / $582.10	Facility		$81.17	$243.78	$582.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.17 / $81.17 / $101.12	Professional		$81.17	$81.17	$101.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $157.38 / $157.38 / $157.38	Professional		$157.38	$157.38	$157.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $157.38 / $157.38 / $157.38	Professional		$157.38	$157.38	$157.38
United Facility/Professional Professional Modifier Low / Median / High Price $61.50 / $91.52 / $161.53	Professional		$61.50	$91.52	$161.53