Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $80.72 / $156.94 / $14,128.30	Facility		$80.72	$156.94	$14,128.30
Aetna Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $79.15 / $107.62	Professional		$78.37	$79.15	$107.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $97.96 / $144.97 / $174.77	Facility		$97.96	$144.97	$174.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.37 / $105.79	Professional		$78.37	$78.37	$105.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $78.37 / $109.72 / $143.63	Facility		$78.37	$109.72	$143.63
CareSource Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $78.47 / $181.70	Professional		$78.37	$78.47	$181.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.37 / $114.80 / $210.02	Facility		$78.37	$114.80	$210.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $98.72 / $144.75	Professional		$78.37	$98.72	$144.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $55.64 / $78.47 / $130.97	Facility		$55.64	$78.47	$130.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $35.01 / $156.74 / $156.74	Professional		$35.01	$156.74	$156.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.64 / $78.47 / $117.71	Facility		$55.64	$78.47	$117.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $78.47 / $87.35 / $933.66	Professional		$78.47	$87.35	$933.66
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 $55.64 / $78.47 / $130.97	Facility		$55.64	$78.47	$130.97
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $35.01 / $156.74 / $156.74	Professional		$35.01	$156.74	$156.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $116.68 / $238.00	Professional		$78.37	$116.68	$238.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $78.37 / $78.37 / $387.60	Facility		$78.37	$78.37	$387.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $141.84 / $933.66	Professional		$78.37	$141.84	$933.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.72 / $110.03 / $114.65	Professional		$75.72	$110.03	$114.65
United Facility/Professional Professional Modifier Low / Median / High Price $78.37 / $80.73 / $98.75	Professional		$78.37	$80.73	$98.75