Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.95 / $94.34 / $111.12	Facility		$48.95	$94.34	$111.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $49.45 / $6,061.83	Professional		$47.53	$49.45	$6,061.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.41 / $87.91 / $105.97	Facility		$59.41	$87.91	$105.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $47.53 / $60.36	Professional		$47.53	$47.53	$60.36
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.08 / $65.08 / $76.05	Facility		$65.08	$65.08	$76.05
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.52 / $60.51 / $136.29	Facility		$47.52	$60.51	$136.29
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $70.15 / $79.70	Professional		$48.98	$70.15	$79.70
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.46 / $48.38 / $48.72	Facility		$32.46	$48.38	$48.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $23.78 / $95.06 / $95.06	Professional		$23.78	$95.06	$95.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $15.24 / $48.38 / $48.72	Facility		$15.24	$48.38	$48.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.38 / $54.19 / $95.06	Professional		$48.38	$54.19	$95.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.06 / $65.00 / $85.00	Professional		$48.06	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $32.46 / $48.38 / $48.72	Facility		$32.46	$48.38	$48.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $23.78 / $95.06 / $95.06	Professional		$23.78	$95.06	$95.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $50.38 / $164.25	Professional		$47.52	$50.38	$164.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $240.30 / $240.30 / $240.30	Facility		$240.30	$240.30	$240.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.52 / $47.52 / $47.52	Professional		$47.52	$47.52	$47.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $48.38 / $48.38 / $48.38	Professional		$48.38	$48.38	$48.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $44.34 / $66.73 / $69.14	Professional		$44.34	$66.73	$69.14
United Facility/Professional Professional Modifier Low / Median / High Price $47.53 / $53.23 / $99.81	Professional		$47.53	$53.23	$99.81