Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $65.83 / $65.83 / $65.83	Facility		$65.83	$65.83	$65.83
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.34 / $65.83 / $101.30	Professional		$53.34	$65.83	$101.30
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $130.49 / $143.54 / $237.49	Facility		$130.49	$143.54	$237.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.44 / $121.36 / $160.50	Professional		$117.44	$121.36	$160.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $93.87 / $279.25 / $279.25	Facility		$93.87	$279.25	$279.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.80 / $270.18 / $544.42	Facility		$75.80	$270.18	$544.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $188.91 / $246.96	Professional		$55.33	$188.91	$246.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $34.70 / $98.75 / $150.06	Facility		$34.70	$98.75	$150.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $74.72 / $130.49 / $156.59	Professional		$74.72	$130.49	$156.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.07 / $130.49 / $563.66	Facility		$60.07	$130.49	$563.66
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.99 / $65.09 / $142.08	Professional		$51.99	$65.09	$142.08
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 $34.70 / $98.75 / $150.06	Facility		$34.70	$98.75	$150.06
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $74.72 / $130.49 / $156.59	Professional		$74.72	$130.49	$156.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $130.49 / $200.82 / $322.19	Professional		$130.49	$200.82	$322.19
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.80 / $254.86 / $563.66	Facility		$75.80	$254.86	$563.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $75.80 / $689.52	Professional		$55.33	$75.80	$689.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $130.49 / $130.49 / $130.49	Professional		$130.49	$130.49	$130.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $130.49 / $130.49 / $130.49	Professional		$130.49	$130.49	$130.49
United Facility/Professional Facility Modifier Low / Median / High Price $71.80 / $71.80 / $71.80	Facility		$71.80	$71.80	$71.80
United Facility/Professional Professional Modifier Low / Median / High Price $44.79 / $65.09 / $130.49	Professional		$44.79	$65.09	$130.49