Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.10 / $134.51 / $98,471.61	Facility		$62.10	$134.51	$98,471.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $62.10 / $17,235.62	Professional		$60.29	$62.10	$17,235.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.36 / $111.54 / $134.44	Facility		$75.36	$111.54	$134.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $60.29 / $81.39	Professional		$60.29	$60.29	$81.39
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.56 / $81.98 / $110.51	Facility		$58.56	$81.98	$110.51
CareSource Facility/Professional Professional Modifier Low / Median / High Price $58.56 / $60.29 / $139.79	Professional		$58.56	$60.29	$139.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.29 / $77.93 / $162.00	Facility		$60.29	$77.93	$162.00
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $72.23 / $109.43	Professional		$60.29	$72.23	$109.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $55.42 / $60.29 / $66.67	Facility		$55.42	$60.29	$66.67
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $87.84 / $120.58 / $120.58	Professional		$87.84	$120.58	$120.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.42 / $58.56 / $74.53	Facility		$55.42	$58.56	$74.53
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.56 / $65.19 / $2,460.12	Professional		$58.56	$65.19	$2,460.12
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 $55.32 / $60.29 / $66.67	Facility		$55.32	$60.29	$66.67
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $87.84 / $120.58 / $120.58	Professional		$87.84	$120.58	$120.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $91.99 / $178.00	Professional		$60.29	$91.99	$178.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $60.29 / $60.29 / $296.75	Facility		$60.29	$60.29	$296.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $105.96 / $2,460.12	Professional		$60.29	$105.96	$2,460.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $61.23 / $84.65 / $85.65	Professional		$61.23	$84.65	$85.65
United Facility/Professional Professional Modifier Low / Median / High Price $60.29 / $63.91 / $72.19	Professional		$60.29	$63.91	$72.19