Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.41 / $96.00 / $110.25	Facility		$49.41	$96.00	$110.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $48.45 / $55.65	Professional		$47.97	$48.45	$55.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.96 / $88.74 / $106.97	Facility		$59.96	$88.74	$106.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $47.97 / $64.75	Professional		$47.97	$47.97	$64.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.67 / $71.00 / $76.75	Facility		$65.67	$71.00	$76.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $47.97 / $96.82 / $167.95	Facility		$47.97	$96.82	$167.95
Cigna Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $58.84 / $86.10	Professional		$47.97	$58.84	$86.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $47.97 / $48.45 / $55.00	Facility		$47.97	$48.45	$55.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $95.94 / $95.94	Professional		$72.00	$95.94	$95.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $48.00 / $53.33	Facility		$48.00	$48.00	$53.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.00 / $48.00 / $213.78	Professional		$48.00	$48.00	$213.78
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $117.68	Professional		$50.00	$70.00	$117.68
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $47.97 / $48.00 / $55.00	Facility		$47.97	$48.00	$55.00
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $72.00 / $95.94 / $95.94	Professional		$72.00	$95.94	$95.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $74.68 / $162.09	Professional		$47.97	$74.68	$162.09
Quartz Facility/Professional Facility Modifier Low / Median / High Price $48.58 / $241.15 / $241.15	Facility		$48.58	$241.15	$241.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $89.08 / $213.78	Professional		$47.97	$89.08	$213.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $67.34 / $67.34 / $67.34	Professional		$67.34	$67.34	$67.34
United Facility/Professional Facility Modifier Low / Median / High Price $48.23 / $48.23 / $103.69	Facility		$48.23	$48.23	$103.69
United Facility/Professional Professional Modifier Low / Median / High Price $47.97 / $47.97 / $57.56	Professional		$47.97	$47.97	$57.56