Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.78 / $111.99 / $131.93	Facility		$57.78	$111.99	$131.93
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $57.78 / $98.66	Professional		$56.10	$57.78	$98.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $70.13 / $103.79 / $125.10	Facility		$70.13	$103.79	$125.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $56.10 / $75.73	Professional		$56.10	$56.10	$75.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.80 / $76.80 / $89.76	Facility		$76.80	$76.80	$89.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.10 / $128.22 / $183.28	Facility		$56.10	$128.22	$183.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.54 / $78.98 / $89.76	Professional		$54.54	$78.98	$89.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $44.71 / $57.43 / $123.32	Facility		$44.71	$57.43	$123.32
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $86.15 / $112.20 / $112.20	Professional		$86.15	$112.20	$112.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.71 / $57.43 / $126.89	Facility		$44.71	$57.43	$126.89
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.43 / $57.43 / $112.20	Professional		$57.43	$57.43	$112.20
Molina Facility/Professional Professional Modifier Low / Median / High Price $51.98 / $65.00 / $85.00	Professional		$51.98	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $44.71 / $57.43 / $123.32	Facility		$44.71	$57.43	$123.32
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $86.15 / $112.20 / $112.20	Professional		$86.15	$112.20	$112.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $63.14 / $177.10	Professional		$56.10	$63.14	$177.10
Quartz Facility/Professional Facility Modifier Low / Median / High Price $56.10 / $56.10 / $259.89	Facility		$56.10	$56.10	$259.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $56.10 / $56.10	Professional		$56.10	$56.10	$56.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.75 / $78.76 / $78.76	Professional		$60.75	$78.76	$78.76
United Facility/Professional Facility Modifier Low / Median / High Price $56.06 / $56.06 / $56.10	Facility		$56.06	$56.06	$56.10
United Facility/Professional Professional Modifier Low / Median / High Price $56.10 / $56.10 / $76.81	Professional		$56.10	$56.10	$76.81