Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.12 / $59.12 / $59.12	Facility		$59.12	$59.12	$59.12
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.12 / $62.51 / $118.71	Professional		$59.12	$62.51	$118.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.20 / $128.91 / $213.30	Facility		$117.20	$128.91	$213.30
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.48 / $109.00 / $144.15	Professional		$105.48	$109.00	$144.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $84.32 / $250.81 / $250.81	Facility		$84.32	$250.81	$250.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.81 / $242.03 / $489.85	Facility		$75.81	$242.03	$489.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.35 / $169.69 / $221.80	Professional		$55.35	$169.69	$221.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $37.34 / $88.68 / $134.78	Facility		$37.34	$88.68	$134.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $117.20 / $154.59	Professional		$67.09	$117.20	$154.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $59.12 / $117.20 / $608.40	Facility		$59.12	$117.20	$608.40
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.79 / $67.48 / $132.31	Professional		$52.79	$67.48	$132.31
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.96 / $55.00 / $85.00	Professional		$44.96	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $37.34 / $88.68 / $134.78	Facility		$37.34	$88.68	$134.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $67.09 / $117.20 / $154.59	Professional		$67.09	$117.20	$154.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.20 / $180.37 / $347.28	Professional		$117.20	$180.37	$347.28
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.81 / $228.90 / $608.40	Facility		$75.81	$228.90	$608.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.35 / $75.81 / $798.48	Professional		$55.35	$75.81	$798.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.20 / $117.20 / $117.20	Professional		$117.20	$117.20	$117.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.20 / $117.20 / $117.20	Professional		$117.20	$117.20	$117.20
United Facility/Professional Facility Modifier Low / Median / High Price $88.00 / $88.00 / $88.00	Facility		$88.00	$88.00	$88.00
United Facility/Professional Professional Modifier Low / Median / High Price $46.69 / $58.81 / $112.07	Professional		$46.69	$58.81	$112.07