Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.20 / $79.20 / $79.20	Facility		$79.20	$79.20	$79.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.35 / $70.76 / $92.64	Professional		$49.35	$70.76	$92.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.30 / $209.85 / $209.85	Facility		$115.30	$209.85	$209.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.23 / $107.24 / $155.66	Professional		$107.23	$107.24	$155.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.57 / $71.70 / $246.76	Facility		$9.57	$71.70	$246.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.97 / $73.97 / $304.58	Facility		$73.97	$73.97	$304.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.97 / $132.38 / $165.47	Professional		$73.97	$132.38	$165.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.38 / $106.30 / $152.81	Facility		$36.38	$106.30	$152.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $76.08 / $76.08 / $159.46	Professional		$76.08	$76.08	$159.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.38 / $152.81 / $530.95	Facility		$36.38	$152.81	$530.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.10 / $65.12 / $145.50	Professional		$52.10	$65.12	$145.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.94 / $55.00 / $65.00	Professional		$37.94	$55.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.38 / $106.30 / $152.81	Facility		$36.38	$106.30	$152.81
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $76.08 / $76.08 / $159.46	Professional		$76.08	$76.08	$159.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15.22 / $24.45 / $31.75	Professional		$15.22	$24.45	$31.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $73.97 / $223.90 / $530.95	Facility		$73.97	$223.90	$530.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.97 / $73.97 / $97.09	Professional		$73.97	$73.97	$97.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $127.94 / $127.94 / $127.94	Professional		$127.94	$127.94	$127.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $127.94 / $127.94 / $127.94	Professional		$127.94	$127.94	$127.94
United Facility/Professional Professional Modifier Low / Median / High Price $41.12 / $61.78 / $138.50	Professional		$41.12	$61.78	$138.50