Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.81 / $82.74 / $126.69	Facility		$56.81	$82.74	$126.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.16 / $56.82 / $94.76	Professional		$55.16	$56.82	$94.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.95 / $68.95 / $68.95	Facility		$68.95	$68.95	$68.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.16 / $55.16 / $82.74	Professional		$55.16	$55.16	$82.74
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.52 / $81.64 / $88.26	Facility		$75.52	$81.64	$88.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.16 / $129.83 / $185.58	Facility		$55.16	$129.83	$185.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $81.22 / $92.30	Professional		$54.60	$81.22	$92.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.60 / $55.16 / $71.03	Facility		$26.60	$55.16	$71.03
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $110.32 / $110.32	Professional		$14.70	$110.32	$110.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.05 / $57.91 / $236.62	Facility		$44.05	$57.91	$236.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.37 / $55.16 / $75.53	Professional		$41.37	$55.16	$75.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.00	Professional		$50.00	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.60 / $55.16 / $71.03	Facility		$26.60	$55.16	$71.03
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $14.70 / $110.32 / $110.32	Professional		$14.70	$110.32	$110.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.16 / $65.11 / $179.38	Professional		$55.16	$65.11	$179.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $54.58 / $85.00 / $236.62	Facility		$54.58	$85.00	$236.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.58 / $55.16 / $55.16	Professional		$54.58	$55.16	$55.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $53.59 / $53.59 / $53.59	Professional		$53.59	$53.59	$53.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.74 / $77.44 / $77.44	Professional		$59.74	$77.44	$77.44
United Facility/Professional Facility Modifier Low / Median / High Price $115.22 / $115.22 / $125.40	Facility		$115.22	$115.22	$125.40
United Facility/Professional Professional Modifier Low / Median / High Price $41.37 / $55.16 / $69.50	Professional		$41.37	$55.16	$69.50