Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.14 / $110.60 / $127.02	Facility		$57.14	$110.60	$127.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $56.03 / $64.34	Professional		$55.47	$56.03	$64.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.34 / $102.62 / $123.70	Facility		$69.34	$102.62	$123.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $55.47 / $74.88	Professional		$55.47	$55.47	$74.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $88.75 / $99.85 / $101.67	Facility		$88.75	$99.85	$101.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.47 / $105.58 / $183.15	Facility		$55.47	$105.58	$183.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $65.25 / $90.31	Professional		$55.47	$65.25	$90.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $55.30 / $55.47 / $61.35	Facility		$55.30	$55.47	$61.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $82.95 / $110.94 / $110.94	Professional		$82.95	$110.94	$110.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.30 / $55.30 / $61.44	Facility		$55.30	$55.30	$61.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.30 / $61.56 / $239.05	Professional		$55.30	$61.56	$239.05
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $55.30 / $55.47 / $61.75	Facility		$55.30	$55.47	$61.75
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $82.95 / $110.94 / $110.94	Professional		$82.95	$110.94	$110.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $84.29 / $180.46	Professional		$55.47	$84.29	$180.46
Quartz Facility/Professional Facility Modifier Low / Median / High Price $54.38 / $55.47 / $271.89	Facility		$54.38	$55.47	$271.89
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $99.61 / $239.05	Professional		$55.47	$99.61	$239.05
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.88 / $77.88 / $80.19	Professional		$77.88	$77.88	$80.19
United Facility/Professional Facility Modifier Low / Median / High Price $55.47 / $55.47 / $55.47	Facility		$55.47	$55.47	$55.47
United Facility/Professional Professional Modifier Low / Median / High Price $55.47 / $58.80 / $66.01	Professional		$55.47	$58.80	$66.01