Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.06 / $77.50 / $129.88	Facility		$65.06	$77.50	$129.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $63.83 / $66.97 / $125.95	Professional		$63.83	$66.97	$125.95
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.96 / $141.86 / $234.71	Facility		$128.96	$141.86	$234.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.06 / $119.93 / $158.62	Professional		$116.06	$119.93	$158.62
CareSource Facility/Professional Facility Modifier Low / Median / High Price $92.78 / $275.97 / $275.97	Facility		$92.78	$275.97	$275.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $266.42 / $538.83	Facility		$77.09	$266.42	$538.83
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $187.03 / $244.08	Professional		$56.28	$187.03	$244.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.21 / $97.59 / $148.30	Facility		$39.21	$97.59	$148.30
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $73.86 / $128.96 / $162.32	Professional		$73.86	$128.96	$162.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $65.06 / $128.96 / $645.14	Facility		$65.06	$128.96	$645.14
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.10 / $73.86 / $145.62	Professional		$58.10	$73.86	$145.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $62.54 / $85.00	Professional		$50.00	$62.54	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.21 / $97.59 / $148.30	Facility		$39.21	$97.59	$148.30
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $73.86 / $128.96 / $162.32	Professional		$73.86	$128.96	$162.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.96 / $198.48 / $364.34	Professional		$128.96	$198.48	$364.34
Quartz Facility/Professional Facility Modifier Low / Median / High Price $77.09 / $251.88 / $645.14	Facility		$77.09	$251.88	$645.14
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.28 / $77.09 / $779.14	Professional		$56.28	$77.09	$779.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $128.96 / $128.96 / $128.96	Professional		$128.96	$128.96	$128.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $128.96 / $128.96 / $128.96	Professional		$128.96	$128.96	$128.96
United Facility/Professional Professional Modifier Low / Median / High Price $50.62 / $70.86 / $114.34	Professional		$50.62	$70.86	$114.34