Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.28 / $55.28 / $55.28	Facility		$55.28	$55.28	$55.28
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.34 / $55.28 / $99.40	Professional		$52.34	$55.28	$99.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.58 / $120.54 / $199.44	Facility		$109.58	$120.54	$199.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.91 / $101.91 / $134.78	Professional		$101.91	$101.91	$134.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $78.83 / $234.50 / $234.50	Facility		$78.83	$234.50	$234.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.81 / $226.07 / $457.66	Facility		$62.81	$226.07	$457.66
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $158.91 / $207.39	Professional		$45.85	$158.91	$207.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.17 / $82.92 / $126.02	Facility		$28.17	$82.92	$126.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $62.74 / $109.58 / $131.50	Professional		$62.74	$109.58	$131.50
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.77 / $109.58 / $468.00	Facility		$48.77	$109.58	$468.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.25 / $54.67 / $119.32	Professional		$43.25	$54.67	$119.32
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.17 / $82.92 / $126.02	Facility		$28.17	$82.92	$126.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $62.74 / $109.58 / $131.50	Professional		$62.74	$109.58	$131.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $109.58 / $166.70 / $261.97	Professional		$109.58	$166.70	$261.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $62.81 / $214.02 / $468.00	Facility		$62.81	$214.02	$468.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $62.81 / $596.48	Professional		$45.85	$62.81	$596.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.58 / $109.58 / $109.58	Professional		$109.58	$109.58	$109.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $87.50 / $109.58 / $109.58	Professional		$87.50	$109.58	$109.58
United Facility/Professional Professional Modifier Low / Median / High Price $36.36 / $54.67 / $104.78	Professional		$36.36	$54.67	$104.78