Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.73 / $64.73 / $64.73	Facility		$64.73	$64.73	$64.73
Aetna Facility/Professional Professional Modifier Low / Median / High Price $64.73 / $74.13 / $136.10	Professional		$64.73	$74.13	$136.10
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $103.99 / $114.39 / $189.26	Facility		$103.99	$114.39	$189.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.71 / $103.99 / $129.97	Professional		$96.71	$103.99	$129.97
CareSource Facility/Professional Facility Modifier Low / Median / High Price $140.40 / $222.54 / $222.54	Facility		$140.40	$222.54	$222.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $128.79 / $386.47 / $498.24	Facility		$128.79	$386.47	$498.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $94.02 / $172.18 / $195.66	Professional		$94.02	$172.18	$195.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.29 / $97.11 / $124.79	Facility		$39.29	$97.11	$124.79
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $53.96 / $103.99 / $124.79	Professional		$53.96	$103.99	$124.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.73 / $120.10 / $532.72	Facility		$64.73	$120.10	$532.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $86.98 / $102.35 / $186.61	Professional		$86.98	$102.35	$186.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.29 / $97.74 / $124.79	Facility		$39.29	$97.74	$124.79
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $53.96 / $103.99 / $124.79	Professional		$53.96	$103.99	$124.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $103.99 / $126.21 / $238.25	Professional		$103.99	$126.21	$238.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $128.79 / $201.92 / $532.72	Facility		$128.79	$201.92	$532.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $94.02 / $128.79 / $811.35	Professional		$94.02	$128.79	$811.35
Security Health Facility/Professional Professional Modifier Low / Median / High Price $158.83 / $158.83 / $158.83	Professional		$158.83	$158.83	$158.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $158.83 / $158.83 / $158.83	Professional		$158.83	$158.83	$158.83
United Facility/Professional Professional Modifier Low / Median / High Price $64.91 / $99.79 / $162.27	Professional		$64.91	$99.79	$162.27