Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $71.26 / $71.26 / $71.26	Facility		$71.26	$71.26	$71.26
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.86 / $62.34 / $82.33	Professional		$43.86	$62.34	$82.33
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.60 / $186.73 / $186.73	Facility		$102.60	$186.73	$186.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.42 / $95.46 / $138.51	Professional		$95.42	$95.46	$138.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.84 / $66.28 / $219.65	Facility		$8.84	$66.28	$219.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.38 / $66.38 / $263.13	Facility		$66.38	$66.38	$263.13
Cigna Facility/Professional Professional Modifier Low / Median / High Price $66.38 / $114.38 / $142.97	Professional		$66.38	$114.38	$142.97
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.02 / $98.28 / $141.28	Facility		$39.02	$98.28	$141.28
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $81.61 / $81.61 / $147.41	Professional		$81.61	$81.61	$147.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.02 / $147.41 / $476.10	Facility		$39.02	$147.41	$476.10
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.19 / $67.93 / $131.82	Professional		$50.19	$67.93	$131.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $85.36	Professional		$50.00	$58.40	$85.36
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.02 / $98.28 / $141.28	Facility		$39.02	$98.28	$141.28
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $81.61 / $81.61 / $147.41	Professional		$81.61	$81.61	$147.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $13.54 / $22.09 / $28.68	Professional		$13.54	$22.09	$28.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $66.38 / $199.32 / $476.10	Facility		$66.38	$199.32	$476.10
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.38 / $66.38 / $87.12	Professional		$66.38	$66.38	$87.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $116.59 / $116.59 / $116.59	Professional		$116.59	$116.59	$116.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $116.59 / $116.59 / $116.59	Professional		$116.59	$116.59	$116.59
United Facility/Professional Professional Modifier Low / Median / High Price $40.97 / $66.27 / $125.48	Professional		$40.97	$66.27	$125.48