Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.07 / $48.07 / $48.07	Facility		$48.07	$48.07	$48.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.07 / $50.94 / $97.88	Professional		$48.07	$50.94	$97.88
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.29 / $104.82 / $173.43	Facility		$95.29	$104.82	$173.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.41 / $88.62 / $117.20	Professional		$82.41	$88.62	$117.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.55 / $203.92 / $203.92	Facility		$68.55	$203.92	$203.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.62 / $197.00 / $397.48	Facility		$61.62	$197.00	$397.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.98 / $138.28 / $180.35	Professional		$44.98	$138.28	$180.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.21 / $72.11 / $109.58	Facility		$26.21	$72.11	$109.58
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $54.54 / $92.52 / $114.35	Professional		$54.54	$92.52	$114.35
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.38 / $95.29 / $434.49	Facility		$45.38	$95.29	$434.49
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.96 / $48.30 / $103.76	Professional		$37.96	$48.30	$103.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.85 / $55.00 / $85.00	Professional		$38.85	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.21 / $72.11 / $109.58	Facility		$26.21	$72.11	$109.58
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $54.54 / $92.52 / $114.35	Professional		$54.54	$92.52	$114.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.29 / $146.63 / $243.90	Professional		$95.29	$146.63	$243.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $61.62 / $186.12 / $434.49	Facility		$61.62	$186.12	$434.49
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.98 / $61.62 / $453.62	Professional		$44.98	$61.62	$453.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $95.29 / $95.29 / $95.29	Professional		$95.29	$95.29	$95.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $95.29 / $95.29 / $95.29	Professional		$95.29	$95.29	$95.29
United Facility/Professional Professional Modifier Low / Median / High Price $31.79 / $47.54 / $91.11	Professional		$31.79	$47.54	$91.11