Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.50 / $65.50 / $65.50	Facility		$65.50	$65.50	$65.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $59.76 / $65.50 / $113.51	Professional		$59.76	$65.50	$113.51
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $129.84 / $142.82 / $236.31	Facility		$129.84	$142.82	$236.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.29 / $120.75 / $159.69	Professional		$112.29	$120.75	$159.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.41 / $277.86 / $277.86	Facility		$93.41	$277.86	$277.86
Cigna Facility/Professional Facility Modifier Low / Median / High Price $83.99 / $268.30 / $541.63	Facility		$83.99	$268.30	$541.63
Cigna Facility/Professional Professional Modifier Low / Median / High Price $61.31 / $187.97 / $245.73	Professional		$61.31	$187.97	$245.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $31.36 / $98.25 / $149.32	Facility		$31.36	$98.25	$149.32
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $129.84 / $155.81	Professional		$74.34	$129.84	$155.81
Medica Facility/Professional Facility Modifier Low / Median / High Price $54.29 / $128.97 / $528.70	Facility		$54.29	$128.97	$528.70
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.15 / $64.78 / $141.38	Professional		$48.15	$64.78	$141.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.86 / $55.00 / $85.00	Professional		$39.86	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $31.36 / $98.25 / $149.32	Facility		$31.36	$98.25	$149.32
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $74.34 / $129.84 / $155.81	Professional		$74.34	$129.84	$155.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $129.84 / $194.76 / $291.07	Professional		$129.84	$194.76	$291.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $83.99 / $253.58 / $528.70	Facility		$83.99	$253.58	$528.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.31 / $83.99 / $743.76	Professional		$61.31	$83.99	$743.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $129.84 / $129.84 / $129.84	Professional		$129.84	$129.84	$129.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $103.67 / $129.84 / $129.84	Professional		$103.67	$129.84	$129.84
United Facility/Professional Professional Modifier Low / Median / High Price $44.11 / $64.78 / $129.84	Professional		$44.11	$64.78	$129.84