Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.23 / $143.30 / $646.34	Facility		$70.23	$143.30	$646.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $70.23 / $95.48	Professional		$68.20	$70.23	$95.48
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $85.25 / $126.17 / $152.09	Facility		$85.25	$126.17	$152.09
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $68.20 / $92.07	Professional		$68.20	$68.20	$92.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $109.12 / $122.76 / $125.01	Facility		$109.12	$122.76	$125.01
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $179.55 / $373.25	Facility		$68.20	$179.55	$373.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.46 / $75.80 / $341.59	Professional		$62.46	$75.80	$341.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $71.65 / $297.69	Facility		$68.20	$71.65	$297.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $107.48 / $136.40 / $166.74	Professional		$107.48	$136.40	$166.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $71.65 / $73.20 / $297.69	Facility		$71.65	$73.20	$297.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $71.65 / $79.76 / $1,771.57	Professional		$71.65	$79.76	$1,771.57
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 $68.20 / $71.65 / $297.69	Facility		$68.20	$71.65	$297.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $107.48 / $136.40 / $166.74	Professional		$107.48	$136.40	$166.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $124.46 / $520.00	Professional		$68.20	$124.46	$520.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $68.20 / $68.20 / $812.19	Facility		$68.20	$68.20	$812.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $525.48 / $1,771.57	Professional		$68.20	$525.48	$1,771.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $85.25 / $95.75 / $125.76	Professional		$85.25	$95.75	$125.76
United Facility/Professional Facility Modifier Low / Median / High Price $59.53 / $59.53 / $127.99	Facility		$59.53	$59.53	$127.99
United Facility/Professional Professional Modifier Low / Median / High Price $68.20 / $70.25 / $85.93	Professional		$68.20	$70.25	$85.93