Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.89 / $53.89 / $53.89	Facility		$53.89	$53.89	$53.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $57.60 / $74.23	Professional		$53.89	$57.60	$74.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $106.82 / $117.50 / $194.41	Facility		$106.82	$117.50	$194.41
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.13 / $99.34 / $131.38	Professional		$96.13	$99.34	$131.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.84 / $228.59 / $228.59	Facility		$76.84	$228.59	$228.59
Cigna Facility/Professional Facility Modifier Low / Median / High Price $66.78 / $220.45 / $446.46	Facility		$66.78	$220.45	$446.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $154.69 / $202.18	Professional		$48.75	$154.69	$202.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.31 / $80.84 / $122.84	Facility		$28.31	$80.84	$122.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.17 / $106.82 / $128.18	Professional		$61.17	$106.82	$128.18
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.00 / $106.82 / $471.51	Facility		$49.00	$106.82	$471.51
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.56 / $53.29 / $116.32	Professional		$42.56	$53.29	$116.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.87 / $55.00 / $85.00	Professional		$43.87	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.31 / $80.84 / $122.84	Facility		$28.31	$80.84	$122.84
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $61.17 / $106.82 / $128.18	Professional		$61.17	$106.82	$128.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $106.82 / $164.39 / $262.97	Professional		$106.82	$164.39	$262.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $66.78 / $208.64 / $471.51	Facility		$66.78	$208.64	$471.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $66.78 / $668.93	Professional		$48.75	$66.78	$668.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $106.82 / $106.82 / $106.82	Professional		$106.82	$106.82	$106.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $106.82 / $106.82 / $106.82	Professional		$106.82	$106.82	$106.82
United Facility/Professional Facility Modifier Low / Median / High Price $140.62 / $140.62 / $140.62	Facility		$140.62	$140.62	$140.62
United Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $53.29 / $102.14	Professional		$39.81	$53.29	$102.14