Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.32 / $110.18 / $165.27	Facility		$57.32	$110.18	$165.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.65 / $57.32 / $102.70	Professional		$55.65	$57.32	$102.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.56 / $102.95 / $124.10	Facility		$69.56	$102.95	$124.10
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.65 / $55.65 / $75.12	Professional		$55.65	$55.65	$75.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $55.09 / $77.13 / $102.00	Facility		$55.09	$77.13	$102.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $55.65 / $129.03	Professional		$55.09	$55.65	$129.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.65 / $75.40 / $137.93	Facility		$55.65	$75.40	$137.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.42 / $66.05 / $83.45	Professional		$54.42	$66.05	$83.45
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $44.76 / $55.65 / $95.81	Facility		$44.76	$55.65	$95.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $82.64 / $111.30 / $111.30	Professional		$82.64	$111.30	$111.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.76 / $55.09 / $79.44	Facility		$44.76	$55.09	$79.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $61.33 / $2,122.62	Professional		$55.09	$61.33	$2,122.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $85.00	Professional		$50.00	$70.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $44.76 / $55.65 / $95.81	Facility		$44.76	$55.65	$95.81
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $82.64 / $111.30 / $111.30	Professional		$82.64	$111.30	$111.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.65 / $60.38 / $161.00	Professional		$55.65	$60.38	$161.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $55.65 / $55.65 / $259.25	Facility		$55.65	$55.65	$259.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.65 / $95.61 / $2,122.62	Professional		$55.65	$95.61	$2,122.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $45.38 / $78.13 / $78.13	Professional		$45.38	$78.13	$78.13
United Facility/Professional Professional Modifier Low / Median / High Price $55.65 / $58.99 / $70.41	Professional		$55.65	$58.99	$70.41