Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.23 / $47.23 / $47.23	Facility		$47.23	$47.23	$47.23
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.23 / $49.22 / $101.53	Professional		$47.23	$49.22	$101.53
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.62 / $102.98 / $170.39	Facility		$93.62	$102.98	$170.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.25 / $87.07 / $115.15	Professional		$84.25	$87.07	$115.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.34 / $200.35 / $200.35	Facility		$67.34	$200.35	$200.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.55 / $193.27 / $390.48	Facility		$60.55	$193.27	$390.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.20 / $135.47 / $177.19	Professional		$44.20	$135.47	$177.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.52 / $70.84 / $107.66	Facility		$28.52	$70.84	$107.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $53.60 / $93.62 / $118.06	Professional		$53.60	$93.62	$118.06
Medica Facility/Professional Facility Modifier Low / Median / High Price $47.23 / $93.62 / $470.06	Facility		$47.23	$93.62	$470.06
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.84 / $52.55 / $105.69	Professional		$40.84	$52.55	$105.69
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 $28.52 / $70.84 / $107.66	Facility		$28.52	$70.84	$107.66
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $53.60 / $93.62 / $118.06	Professional		$53.60	$93.62	$118.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.62 / $144.09 / $264.98	Professional		$93.62	$144.09	$264.98
Quartz Facility/Professional Facility Modifier Low / Median / High Price $60.55 / $182.86 / $470.06	Facility		$60.55	$182.86	$470.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.20 / $60.55 / $942.93	Professional		$44.20	$60.55	$942.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.62 / $93.62 / $93.62	Professional		$93.62	$93.62	$93.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.75 / $93.62 / $93.62	Professional		$74.75	$93.62	$93.62
United Facility/Professional Facility Modifier Low / Median / High Price $141.66 / $141.66 / $141.66	Facility		$141.66	$141.66	$141.66
United Facility/Professional Professional Modifier Low / Median / High Price $36.82 / $51.54 / $83.01	Professional		$36.82	$51.54	$83.01