Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.35 / $108.19 / $127.45	Facility		$56.35	$108.19	$127.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $56.35 / $164.56	Professional		$54.71	$56.35	$164.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.39 / $101.21 / $122.00	Facility		$68.39	$101.21	$122.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $54.71 / $69.48	Professional		$54.71	$54.71	$69.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $74.91 / $74.91 / $87.54	Facility		$74.91	$74.91	$87.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.71 / $135.54 / $193.75	Facility		$54.71	$135.54	$193.75
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.90 / $87.93 / $99.93	Professional		$57.90	$87.93	$99.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $54.71 / $55.48 / $68.83	Facility		$54.71	$55.48	$68.83
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $109.42 / $109.42	Professional		$39.28	$109.42	$109.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.48 / $55.48 / $68.83	Facility		$55.48	$55.48	$68.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.48 / $55.48 / $109.42	Professional		$55.48	$55.48	$109.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $56.83 / $65.00 / $85.00	Professional		$56.83	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $54.71 / $55.48 / $68.83	Facility		$54.71	$55.48	$68.83
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $39.28 / $109.42 / $109.42	Professional		$39.28	$109.42	$109.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $57.99 / $186.94	Professional		$54.71	$57.99	$186.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $314.05 / $314.05 / $314.05	Facility		$314.05	$314.05	$314.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $54.71 / $54.71	Professional		$54.71	$54.71	$54.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.48 / $55.48 / $55.48	Professional		$55.48	$55.48	$55.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $76.81 / $76.81 / $104.59	Professional		$76.81	$76.81	$104.59
United Facility/Professional Professional Modifier Low / Median / High Price $54.71 / $54.71 / $71.12	Professional		$54.71	$54.71	$71.12