Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.32 / $57.32 / $57.32	Facility		$57.32	$57.32	$57.32
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.25 / $57.32 / $100.60	Professional		$51.25	$57.32	$100.60
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.64 / $125.00 / $206.82	Facility		$113.64	$125.00	$206.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $98.29 / $105.69 / $139.77	Professional		$98.29	$105.69	$139.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.75 / $243.19 / $243.19	Facility		$81.75	$243.19	$243.19
Cigna Facility/Professional Facility Modifier Low / Median / High Price $71.02 / $234.53 / $474.45	Facility		$71.02	$234.53	$474.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.84 / $164.53 / $215.06	Professional		$51.84	$164.53	$215.06
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.45 / $85.98 / $130.69	Facility		$27.45	$85.98	$130.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $101.16 / $136.37	Professional		$65.06	$101.16	$136.37
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.51 / $113.64 / $457.61	Facility		$47.51	$113.64	$457.61
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.14 / $56.69 / $123.74	Professional		$42.14	$56.69	$123.74
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 $27.45 / $85.98 / $130.69	Facility		$27.45	$85.98	$130.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $65.06 / $101.16 / $136.37	Professional		$65.06	$101.16	$136.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $113.64 / $170.46 / $254.94	Professional		$113.64	$170.46	$254.94
Quartz Facility/Professional Facility Modifier Low / Median / High Price $71.02 / $221.94 / $457.61	Facility		$71.02	$221.94	$457.61
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.84 / $71.02 / $499.37	Professional		$51.84	$71.02	$499.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $113.64 / $113.64 / $113.64	Professional		$113.64	$113.64	$113.64
Security Health Facility/Professional Professional Modifier Low / Median / High Price $68.98 / $113.64 / $113.64	Professional		$68.98	$113.64	$113.64
United Facility/Professional Professional Modifier Low / Median / High Price $37.79 / $56.69 / $113.64	Professional		$37.79	$56.69	$113.64