Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.59 / $128.16 / $150.97	Facility		$67.59	$128.16	$150.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $67.59 / $147.24	Professional		$65.63	$67.59	$147.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.04 / $121.42 / $146.35	Facility		$82.04	$121.42	$146.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $83.35	Professional		$65.63	$65.63	$83.35
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.85 / $89.85 / $105.01	Facility		$89.85	$89.85	$105.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.63 / $83.58 / $178.69	Facility		$65.63	$83.58	$178.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $97.57 / $110.88	Professional		$65.63	$97.57	$110.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $49.68 / $65.73 / $144.69	Facility		$49.68	$65.73	$144.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $98.60 / $131.26 / $131.26	Professional		$98.60	$131.26	$131.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.68 / $65.73 / $144.69	Facility		$49.68	$65.73	$144.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $65.73 / $65.73 / $131.26	Professional		$65.73	$65.73	$131.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $63.88 / $65.00 / $85.00	Professional		$63.88	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $49.68 / $65.73 / $144.69	Facility		$49.68	$65.73	$144.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $98.60 / $131.26 / $131.26	Professional		$98.60	$131.26	$131.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.62 / $99.01 / $198.00	Professional		$65.62	$99.01	$198.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $319.39 / $319.39 / $319.39	Facility		$319.39	$319.39	$319.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $65.63	Professional		$65.63	$65.63	$65.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $67.53 / $92.14 / $95.27	Professional		$67.53	$92.14	$95.27
United Facility/Professional Facility Modifier Low / Median / High Price $63.88 / $63.88 / $149.47	Facility		$63.88	$63.88	$149.47
United Facility/Professional Professional Modifier Low / Median / High Price $65.63 / $65.63 / $89.86	Professional		$65.63	$65.63	$89.86