Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $60.99 / $60.99 / $60.99	Facility		$60.99	$60.99	$60.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.29 / $60.99 / $89.81	Professional		$47.29	$60.99	$89.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $120.89 / $132.97 / $220.02	Facility		$120.89	$132.97	$220.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.55 / $112.43 / $148.69	Professional		$104.55	$112.43	$148.69
CareSource Facility/Professional Facility Modifier Low / Median / High Price $86.97 / $258.70 / $258.70	Facility		$86.97	$258.70	$258.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.68 / $249.54 / $505.24	Facility		$71.68	$249.54	$505.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.33 / $175.31 / $228.80	Professional		$52.33	$175.31	$228.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.21 / $91.49 / $139.02	Facility		$30.21	$91.49	$139.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $69.20 / $120.89 / $145.07	Professional		$69.20	$120.89	$145.07
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.30 / $120.89 / $496.97	Facility		$52.30	$120.89	$496.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.38 / $60.31 / $131.63	Professional		$46.38	$60.31	$131.63
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.83 / $60.78 / $85.00	Professional		$49.83	$60.78	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $30.21 / $91.49 / $139.02	Facility		$30.21	$91.49	$139.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $69.20 / $120.89 / $145.07	Professional		$69.20	$120.89	$145.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $120.89 / $181.34 / $281.04	Professional		$120.89	$181.34	$281.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $71.68 / $236.12 / $496.97	Facility		$71.68	$236.12	$496.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.33 / $71.68 / $600.34	Professional		$52.33	$71.68	$600.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $120.89 / $120.89 / $120.89	Professional		$120.89	$120.89	$120.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $120.89 / $120.89 / $120.89	Professional		$120.89	$120.89	$120.89
United Facility/Professional Facility Modifier Low / Median / High Price $150.08 / $150.08 / $150.08	Facility		$150.08	$150.08	$150.08
United Facility/Professional Professional Modifier Low / Median / High Price $40.21 / $60.31 / $115.60	Professional		$40.21	$60.31	$115.60