Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.58 / $150.68 / $177.46	Facility		$79.58	$150.68	$177.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $77.39 / $79.70 / $184.68	Professional		$77.39	$79.70	$184.68
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $96.74 / $143.16 / $172.58	Facility		$96.74	$143.16	$172.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.39 / $77.39 / $98.28	Professional		$77.39	$77.39	$98.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $105.95 / $105.95 / $123.82	Facility		$105.95	$105.95	$123.82
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.39 / $98.58 / $209.10	Facility		$77.39	$98.58	$209.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $77.95 / $113.78 / $129.30	Professional		$77.95	$113.78	$129.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $64.92 / $77.27 / $170.37	Facility		$64.92	$77.27	$170.37
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $115.91 / $154.78 / $154.78	Professional		$115.91	$154.78	$154.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.92 / $77.27 / $170.37	Facility		$64.92	$77.27	$170.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $77.27 / $86.54 / $154.78	Professional		$77.27	$86.54	$154.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $77.30 / $85.00	Professional		$65.00	$77.30	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $64.92 / $77.27 / $170.37	Facility		$64.92	$77.27	$170.37
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $115.91 / $154.78 / $154.78	Professional		$115.91	$154.78	$154.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $77.39 / $82.03 / $256.10	Professional		$77.39	$82.03	$256.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $375.85 / $375.85 / $375.85	Facility		$375.85	$375.85	$375.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $77.39 / $77.39 / $77.39	Professional		$77.39	$77.39	$77.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.27 / $77.27 / $77.27	Professional		$77.27	$77.27	$77.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $88.15 / $108.66 / $111.54	Professional		$88.15	$108.66	$111.54
United Facility/Professional Professional Modifier Low / Median / High Price $77.39 / $86.68 / $103.44	Professional		$77.39	$86.68	$103.44