Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.81 / $123.56 / $298.62	Facility		$71.81	$123.56	$298.62
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $71.81 / $141.51	Professional		$69.73	$71.81	$141.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.16 / $87.16 / $87.16	Facility		$87.16	$87.16	$87.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $104.59	Professional		$69.73	$69.73	$104.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $95.47 / $103.20 / $111.57	Facility		$95.47	$103.20	$111.57
Cigna Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $207.65 / $296.82	Facility		$69.73	$207.65	$296.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $81.00 / $83.43 / $101.25	Professional		$81.00	$83.43	$101.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $82.37 / $107.73	Facility		$69.73	$82.37	$107.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $33.14 / $139.46 / $139.46	Professional		$33.14	$139.46	$139.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $82.37 / $100.68 / $350.53	Facility		$82.37	$100.68	$350.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.14 / $82.37 / $139.46	Professional		$33.14	$82.37	$139.46
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $90.00	Professional		$50.00	$65.00	$90.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $69.73 / $82.37 / $107.73	Facility		$69.73	$82.37	$107.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $33.14 / $139.46 / $139.46	Professional		$33.14	$139.46	$139.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $90.65 / $269.50	Professional		$69.73	$90.65	$269.50
Quartz Facility/Professional Facility Modifier Low / Median / High Price $79.50 / $95.63 / $350.53	Facility		$79.50	$95.63	$350.53
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.73 / $69.73 / $95.63	Professional		$69.73	$69.73	$95.63
Security Health Facility/Professional Professional Modifier Low / Median / High Price $82.37 / $82.37 / $82.37	Professional		$82.37	$82.37	$82.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.90 / $97.90 / $137.11	Professional		$97.90	$97.90	$137.11
United Facility/Professional Professional Modifier Low / Median / High Price $59.27 / $69.73 / $104.60	Professional		$59.27	$69.73	$104.60