Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $84.52 / $84.52 / $84.52	Facility		$84.52	$84.52	$84.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.22 / $73.80 / $96.14	Professional		$51.22	$73.80	$96.14
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.00 / $225.68 / $225.68	Facility		$124.00	$225.68	$225.68
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $115.32 / $115.35 / $167.40	Professional		$115.32	$115.35	$167.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $9.99 / $74.95 / $265.42	Facility		$9.99	$74.95	$265.42
Cigna Facility/Professional Facility Modifier Low / Median / High Price $78.15 / $78.15 / $318.10	Facility		$78.15	$78.15	$318.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $78.15 / $138.00 / $172.50	Professional		$78.15	$138.00	$172.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $38.03 / $111.14 / $159.76	Facility		$38.03	$111.14	$159.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $79.54 / $79.54 / $166.70	Professional		$79.54	$79.54	$166.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.03 / $159.76 / $560.90	Facility		$38.03	$159.76	$560.90
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.47 / $68.09 / $152.59	Professional		$54.47	$68.09	$152.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $88.15	Professional		$50.00	$58.40	$88.15
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $38.03 / $111.14 / $159.76	Facility		$38.03	$111.14	$159.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $79.54 / $79.54 / $166.70	Professional		$79.54	$79.54	$166.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $16.37 / $26.03 / $33.79	Professional		$16.37	$26.03	$33.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $78.15 / $240.84 / $560.90	Facility		$78.15	$240.84	$560.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.15 / $78.15 / $92.68	Professional		$78.15	$78.15	$92.68
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.49 / $134.49 / $134.49	Professional		$134.49	$134.49	$134.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $134.49 / $134.49 / $134.49	Professional		$134.49	$134.49	$134.49
United Facility/Professional Professional Modifier Low / Median / High Price $48.42 / $66.22 / $145.25	Professional		$48.42	$66.22	$145.25