Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $64.95 / $64.95 / $64.95	Facility		$64.95	$64.95	$64.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $61.14 / $64.95 / $116.13	Professional		$61.14	$64.95	$116.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $128.76 / $141.63 / $234.34	Facility		$128.76	$141.63	$234.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $119.75 / $119.75 / $158.37	Professional		$119.75	$119.75	$158.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $92.63 / $275.55 / $275.55	Facility		$92.63	$275.55	$275.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $80.45 / $266.42 / $537.42	Facility		$80.45	$266.42	$537.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.73 / $186.56 / $243.69	Professional		$58.73	$186.56	$243.69
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $41.47 / $97.44 / $148.07	Facility		$41.47	$97.44	$148.07
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $73.72 / $128.76 / $171.68	Professional		$73.72	$128.76	$171.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $64.95 / $128.35 / $675.46	Facility		$64.95	$128.35	$675.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.32 / $74.94 / $145.36	Professional		$58.32	$74.94	$145.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.82 / $55.89 / $85.00	Professional		$45.82	$55.89	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $41.47 / $97.44 / $148.07	Facility		$41.47	$97.44	$148.07
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $73.72 / $128.76 / $171.68	Professional		$73.72	$128.76	$171.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $128.76 / $198.15 / $385.42	Professional		$128.76	$198.15	$385.42
Quartz Facility/Professional Facility Modifier Low / Median / High Price $80.45 / $251.48 / $675.46	Facility		$80.45	$251.48	$675.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.73 / $80.45 / $892.26	Professional		$58.73	$80.45	$892.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $128.76 / $128.76 / $128.76	Professional		$128.76	$128.76	$128.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $128.76 / $128.76 / $128.76	Professional		$128.76	$128.76	$128.76
United Facility/Professional Professional Modifier Low / Median / High Price $51.30 / $74.23 / $128.76	Professional		$51.30	$74.23	$128.76