Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.08 / $68.08 / $68.08	Facility		$68.08	$68.08	$68.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.22 / $63.22 / $80.95	Professional		$43.22	$63.22	$80.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.18 / $112.40 / $185.97	Facility		$102.18	$112.40	$185.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.03 / $95.03 / $125.68	Professional		$91.03	$95.03	$125.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.51 / $218.67 / $218.67	Facility		$73.51	$218.67	$218.67
Cigna Facility/Professional Facility Modifier Low / Median / High Price $159.47 / $181.23 / $492.69	Facility		$159.47	$181.23	$492.69
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.91 / $170.18 / $193.39	Professional		$43.91	$170.18	$193.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $31.87 / $102.12 / $122.54	Facility		$31.87	$102.12	$122.54
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $122.62 / $122.62 / $122.62	Professional		$122.62	$122.62	$122.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.68 / $111.82 / $476.75	Facility		$59.68	$111.82	$476.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.64 / $54.29 / $111.82	Professional		$45.64	$54.29	$111.82
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $81.89	Professional		$50.00	$65.00	$81.89
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $31.87 / $102.12 / $122.54	Facility		$31.87	$102.12	$122.54
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $122.62 / $122.62 / $122.62	Professional		$122.62	$122.62	$122.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.18 / $157.27 / $274.01	Professional		$102.18	$157.27	$274.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $199.58 / $199.58 / $476.75	Facility		$199.58	$199.58	$476.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.91 / $85.76 / $514.42	Professional		$43.91	$85.76	$514.42
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.18 / $102.18 / $102.18	Professional		$102.18	$102.18	$102.18
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.18 / $102.18 / $102.18	Professional		$102.18	$102.18	$102.18
United Facility/Professional Professional Modifier Low / Median / High Price $35.72 / $52.60 / $97.72	Professional		$35.72	$52.60	$97.72