Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.52 / $78.52 / $78.52	Facility		$78.52	$78.52	$78.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.52 / $80.00 / $124.44	Professional		$65.52	$80.00	$124.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $155.65 / $171.22 / $283.27	Facility		$155.65	$171.22	$283.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $134.61 / $144.75 / $191.44	Professional		$134.61	$144.75	$191.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.97 / $333.09 / $333.09	Facility		$111.97	$333.09	$333.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.21 / $321.75 / $649.40	Facility		$86.21	$321.75	$649.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.93 / $225.47 / $294.58	Professional		$62.93	$225.47	$294.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $44.44 / $117.78 / $179.00	Facility		$44.44	$117.78	$179.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $137.97 / $186.78	Professional		$89.13	$137.97	$186.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $76.93 / $155.65 / $706.68	Facility		$76.93	$155.65	$706.68
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.64 / $81.53 / $169.48	Professional		$63.64	$81.53	$169.48
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $66.43 / $110.72	Professional		$50.00	$66.43	$110.72
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $44.44 / $117.78 / $179.00	Facility		$44.44	$117.78	$179.00
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $89.13 / $137.97 / $186.78	Professional		$89.13	$137.97	$186.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $155.65 / $239.56 / $412.52	Professional		$155.65	$239.56	$412.52
Quartz Facility/Professional Facility Modifier Low / Median / High Price $86.21 / $304.00 / $706.68	Facility		$86.21	$304.00	$706.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.93 / $86.21 / $910.65	Professional		$62.93	$86.21	$910.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $155.65 / $155.65 / $155.65	Professional		$155.65	$155.65	$155.65
Security Health Facility/Professional Professional Modifier Low / Median / High Price $155.65 / $155.65 / $155.65	Professional		$155.65	$155.65	$155.65
United Facility/Professional Professional Modifier Low / Median / High Price $53.90 / $77.65 / $138.00	Professional		$53.90	$77.65	$138.00