Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.11 / $53.11 / $53.11	Facility		$53.11	$53.11	$53.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.16 / $53.11 / $89.56	Professional		$47.16	$53.11	$89.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.28 / $115.81 / $191.61	Facility		$105.28	$115.81	$191.61
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $97.91 / $97.91 / $129.49	Professional		$97.91	$97.91	$129.49
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.73 / $225.30 / $225.30	Facility		$75.73	$225.30	$225.30
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.27 / $217.64 / $439.46	Facility		$73.27	$217.64	$439.46
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.49 / $152.34 / $199.25	Professional		$53.49	$152.34	$199.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $31.30 / $79.67 / $121.07	Facility		$31.30	$79.67	$121.07
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $105.28 / $129.59	Professional		$60.26	$105.28	$129.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.11 / $105.28 / $510.63	Facility		$53.11	$105.28	$510.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.83 / $56.57 / $118.83	Professional		$44.83	$56.57	$118.83
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 $31.30 / $79.67 / $121.07	Facility		$31.30	$79.67	$121.07
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $60.26 / $105.28 / $129.59	Professional		$60.26	$105.28	$129.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $105.28 / $162.01 / $291.07	Professional		$105.28	$162.01	$291.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $73.27 / $205.62 / $510.63	Facility		$73.27	$205.62	$510.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $53.49 / $73.27 / $673.20	Professional		$53.49	$73.27	$673.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.28 / $105.28 / $105.28	Professional		$105.28	$105.28	$105.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.28 / $105.28 / $105.28	Professional		$105.28	$105.28	$105.28
United Facility/Professional Professional Modifier Low / Median / High Price $40.40 / $52.52 / $93.34	Professional		$40.40	$52.52	$93.34