Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.34 / $121.82 / $143.47	Facility		$64.34	$121.82	$143.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.68 / $65.59 / $140.59	Professional		$63.68	$65.59	$140.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $79.59 / $117.81 / $142.01	Facility		$79.59	$117.81	$142.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $63.68 / $63.68 / $80.87	Professional		$63.68	$63.68	$80.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.19 / $87.19 / $101.89	Facility		$87.19	$87.19	$101.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.68 / $77.53 / $161.18	Facility		$63.68	$77.53	$161.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.09 / $86.01 / $97.74	Professional		$60.09	$86.01	$97.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.06 / $62.47 / $140.44	Facility		$42.06	$62.47	$140.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $93.71 / $127.36 / $127.36	Professional		$93.71	$127.36	$127.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.06 / $62.47 / $137.58	Facility		$42.06	$62.47	$137.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.47 / $69.97 / $127.36	Professional		$62.47	$69.97	$127.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $57.48 / $65.00 / $85.00	Professional		$57.48	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $42.06 / $62.47 / $140.44	Facility		$42.06	$62.47	$140.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $93.71 / $127.36 / $127.36	Professional		$93.71	$127.36	$127.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.68 / $64.75 / $189.11	Professional		$63.68	$64.75	$189.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $287.39 / $287.39 / $287.39	Facility		$287.39	$287.39	$287.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.68 / $63.68 / $63.68	Professional		$63.68	$63.68	$63.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.47 / $62.47 / $62.47	Professional		$62.47	$62.47	$62.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.36 / $89.41 / $89.41	Professional		$57.36	$89.41	$89.41
United Facility/Professional Professional Modifier Low / Median / High Price $63.68 / $71.31 / $89.15	Professional		$63.68	$71.31	$89.15