Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $92.53 / $92.53 / $92.53	Facility		$92.53	$92.53	$92.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.82 / $81.76 / $104.77	Professional		$55.82	$81.76	$104.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $135.60 / $246.79 / $246.79	Facility		$135.60	$246.79	$246.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.16 / $126.11 / $166.78	Professional		$107.16	$126.11	$166.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.98 / $82.33 / $290.18	Facility		$10.98	$82.33	$290.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $45.00 / $353.24	Facility		$45.00	$45.00	$353.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $153.38 / $191.72	Professional		$45.00	$153.38	$191.72
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.79 / $122.12 / $175.55	Facility		$41.79	$122.12	$175.55
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $87.40 / $87.40 / $183.18	Professional		$87.40	$87.40	$183.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $41.79 / $175.55 / $615.09	Facility		$41.79	$175.55	$615.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $59.85 / $74.81 / $167.16	Professional		$59.85	$74.81	$167.16
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.57 / $58.40 / $72.63	Professional		$43.57	$58.40	$72.63
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $41.79 / $122.12 / $175.55	Facility		$41.79	$122.12	$175.55
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $87.40 / $87.40 / $183.18	Professional		$87.40	$87.40	$183.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $17.89 / $28.40 / $36.86	Professional		$17.89	$28.40	$36.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $45.00 / $263.30 / $615.09	Facility		$45.00	$263.30	$615.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.00 / $45.00 / $100.67	Professional		$45.00	$45.00	$100.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.61 / $147.61 / $147.61	Professional		$147.61	$147.61	$147.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.61 / $147.61 / $147.61	Professional		$147.61	$147.61	$147.61
United Facility/Professional Professional Modifier Low / Median / High Price $53.04 / $72.97 / $147.61	Professional		$53.04	$72.97	$147.61