Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.16 / $61.16 / $61.16	Facility		$61.16	$61.16	$61.16
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.04 / $61.16 / $93.13	Professional		$49.04	$61.16	$93.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.24 / $133.36 / $220.66	Facility		$121.24	$133.36	$220.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $109.11 / $112.75 / $149.12	Professional		$109.11	$112.75	$149.12
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.22 / $259.45 / $259.45	Facility		$87.22	$259.45	$259.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.47 / $250.49 / $506.64	Facility		$75.47	$250.49	$506.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $175.78 / $229.46	Professional		$55.09	$175.78	$229.46
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.26 / $91.74 / $139.43	Facility		$33.26	$91.74	$139.43
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $69.42 / $121.24 / $145.49	Professional		$69.42	$121.24	$145.49
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.58 / $121.24 / $539.88	Facility		$57.58	$121.24	$539.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.30 / $61.28 / $132.02	Professional		$48.30	$61.28	$132.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $64.62 / $85.00	Professional		$50.00	$64.62	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $33.26 / $91.74 / $139.43	Facility		$33.26	$91.74	$139.43
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $69.42 / $121.24 / $145.49	Professional		$69.42	$121.24	$145.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $121.24 / $186.58 / $309.14	Professional		$121.24	$186.58	$309.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.47 / $236.80 / $539.88	Facility		$75.47	$236.80	$539.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.09 / $75.47 / $676.08	Professional		$55.09	$75.47	$676.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.24 / $121.24 / $121.24	Professional		$121.24	$121.24	$121.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.24 / $121.24 / $121.24	Professional		$121.24	$121.24	$121.24
United Facility/Professional Professional Modifier Low / Median / High Price $40.34 / $60.49 / $115.93	Professional		$40.34	$60.49	$115.93