Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.38 / $47.38 / $47.38	Facility		$47.38	$47.38	$47.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.85 / $49.16 / $65.25	Professional		$44.85	$49.16	$65.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.91 / $103.30 / $170.92	Facility		$93.91	$103.30	$170.92
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.51 / $87.34 / $115.50	Professional		$84.51	$87.34	$115.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.56 / $200.97 / $200.97	Facility		$67.56	$200.97	$200.97
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.60 / $207.37 / $391.88	Facility		$58.60	$207.37	$391.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.78 / $138.11 / $177.74	Professional		$42.78	$138.11	$177.74
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.03 / $71.06 / $108.00	Facility		$27.03	$71.06	$108.00
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $53.78 / $91.65 / $112.69	Professional		$53.78	$91.65	$112.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.78 / $93.91 / $437.39	Facility		$46.78	$93.91	$437.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.02 / $49.20 / $102.26	Professional		$41.02	$49.20	$102.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $63.38 / $85.00	Professional		$50.00	$63.38	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.03 / $71.06 / $108.00	Facility		$27.03	$71.06	$108.00
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $53.78 / $91.65 / $112.69	Professional		$53.78	$91.65	$112.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.91 / $144.53 / $250.93	Professional		$93.91	$144.53	$250.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $58.60 / $183.42 / $437.39	Facility		$58.60	$183.42	$437.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.78 / $58.60 / $473.70	Professional		$42.78	$58.60	$473.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.91 / $93.91 / $93.91	Professional		$93.91	$93.91	$93.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.00 / $93.91 / $93.91	Professional		$75.00	$93.91	$93.91
United Facility/Professional Professional Modifier Low / Median / High Price $32.78 / $46.85 / $93.91	Professional		$32.78	$46.85	$93.91