Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.64 / $139.74 / $164.60	Facility		$68.64	$139.74	$164.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $68.64 / $123.11	Professional		$66.64	$68.64	$123.11
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.30 / $123.28 / $148.61	Facility		$83.30	$123.28	$148.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $84.63	Professional		$66.64	$66.64	$84.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.24 / $91.24 / $106.62	Facility		$91.24	$91.24	$106.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $125.98 / $180.09	Facility		$66.64	$125.98	$180.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.38 / $68.37 / $82.97	Professional		$66.38	$68.37	$82.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $46.57 / $66.64 / $71.66	Facility		$46.57	$66.64	$71.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $133.28 / $133.28	Professional		$41.69	$133.28	$133.28
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.57 / $71.66 / $71.66	Facility		$46.57	$71.66	$71.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.66 / $80.26 / $133.28	Professional		$71.66	$80.26	$133.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $65.15 / $158.97	Professional		$55.00	$65.15	$158.97
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $46.57 / $66.64 / $71.66	Facility		$46.57	$66.64	$71.66
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $41.69 / $133.28 / $133.28	Professional		$41.69	$133.28	$133.28
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $80.01 / $224.40	Professional		$66.64	$80.01	$224.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $400.46 / $400.46 / $400.46	Facility		$400.46	$400.46	$400.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $66.64 / $66.64	Professional		$66.64	$66.64	$66.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $42.96 / $93.56 / $93.56	Professional		$42.96	$93.56	$93.56
United Facility/Professional Facility Modifier Low / Median / High Price $66.64 / $66.64 / $66.64	Facility		$66.64	$66.64	$66.64
United Facility/Professional Professional Modifier Low / Median / High Price $66.64 / $74.64 / $99.96	Professional		$66.64	$74.64	$99.96