Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $68.19 / $68.19 / $68.19	Facility		$68.19	$68.19	$68.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $54.54 / $68.19 / $103.59	Professional		$54.54	$68.19	$103.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $135.16 / $148.69 / $246.01	Facility		$135.16	$148.69	$246.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.91 / $125.71 / $166.25	Professional		$116.91	$125.71	$166.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $97.24 / $289.26 / $289.26	Facility		$97.24	$289.26	$289.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.42 / $279.57 / $564.02	Facility		$87.42	$279.57	$564.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $195.94 / $255.81	Professional		$63.82	$195.94	$255.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.65 / $102.29 / $155.44	Facility		$32.65	$102.29	$155.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $77.38 / $135.16 / $162.19	Professional		$77.38	$135.16	$162.19
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.51 / $134.66 / $540.12	Facility		$56.51	$134.66	$540.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.12 / $67.43 / $147.19	Professional		$50.12	$67.43	$147.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.49 / $55.00 / $85.00	Professional		$41.49	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $32.65 / $102.29 / $155.44	Facility		$32.65	$102.29	$155.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $77.38 / $135.16 / $162.19	Professional		$77.38	$135.16	$162.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $135.16 / $202.76 / $303.12	Professional		$135.16	$202.76	$303.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $87.42 / $264.00 / $540.12	Facility		$87.42	$264.00	$540.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.82 / $87.42 / $648.82	Professional		$63.82	$87.42	$648.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $135.16 / $135.16 / $135.16	Professional		$135.16	$135.16	$135.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $135.16 / $135.16 / $135.16	Professional		$135.16	$135.16	$135.16
United Facility/Professional Professional Modifier Low / Median / High Price $45.92 / $67.43 / $135.16	Professional		$45.92	$67.43	$135.16