Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.47 / $96.06 / $9,762.49	Facility		$49.47	$96.06	$9,762.49
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $50.43 / $110.54	Professional		$48.96	$50.43	$110.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.20 / $90.58 / $109.18	Facility		$61.20	$90.58	$109.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $48.96 / $62.17	Professional		$48.96	$48.96	$62.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.04 / $67.04 / $78.34	Facility		$67.04	$67.04	$78.34
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.96 / $62.35 / $135.78	Facility		$48.96	$62.35	$135.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.28 / $77.65 / $88.24	Professional		$49.28	$77.65	$88.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.76 / $48.03 / $48.96	Facility		$36.76	$48.03	$48.96
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $22.98 / $97.92 / $97.92	Professional		$22.98	$97.92	$97.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.76 / $48.03 / $127.35	Facility		$36.76	$48.03	$127.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.03 / $53.79 / $97.92	Professional		$48.03	$53.79	$97.92
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.35 / $65.00 / $85.00	Professional		$48.35	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.76 / $48.03 / $48.96	Facility		$36.76	$48.03	$48.96
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $22.98 / $97.92 / $97.92	Professional		$22.98	$97.92	$97.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $51.90 / $164.25	Professional		$48.96	$51.90	$164.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $241.75 / $241.75 / $241.75	Facility		$241.75	$241.75	$241.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $48.96 / $48.96	Professional		$48.96	$48.96	$48.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $48.03 / $48.03 / $48.03	Professional		$48.03	$48.03	$48.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $50.14 / $68.73 / $72.88	Professional		$50.14	$68.73	$72.88
United Facility/Professional Professional Modifier Low / Median / High Price $48.96 / $54.84 / $68.54	Professional		$48.96	$54.84	$68.54