Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.57 / $62.57 / $62.57	Facility		$62.57	$62.57	$62.57
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.57 / $66.98 / $185.25	Professional		$62.57	$66.98	$185.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.04 / $136.44 / $225.75	Facility		$124.04	$136.44	$225.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.63 / $115.36 / $152.56	Professional		$111.63	$115.36	$152.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.23 / $265.45 / $265.45	Facility		$89.23	$265.45	$265.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.33 / $256.08 / $517.84	Facility		$84.33	$256.08	$517.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.86 / $179.53 / $234.75	Professional		$64.86	$179.53	$234.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $35.72 / $93.86 / $142.65	Facility		$35.72	$93.86	$142.65
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $71.01 / $124.04 / $148.85	Professional		$71.01	$124.04	$148.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.86 / $124.04 / $587.62	Facility		$61.86	$124.04	$587.62
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.02 / $64.97 / $138.38	Professional		$52.02	$64.97	$138.38
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 $35.72 / $93.86 / $142.65	Facility		$35.72	$93.86	$142.65
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $71.01 / $124.04 / $148.85	Professional		$71.01	$124.04	$148.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.04 / $190.89 / $332.22	Professional		$124.04	$190.89	$332.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $88.85 / $242.26 / $587.62	Facility		$88.85	$242.26	$587.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.86 / $88.85 / $702.53	Professional		$64.86	$88.85	$702.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $124.04 / $124.04 / $124.04	Professional		$124.04	$124.04	$124.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $99.03 / $124.04 / $124.04	Professional		$99.03	$124.04	$124.04
United Facility/Professional Professional Modifier Low / Median / High Price $43.34 / $61.88 / $109.97	Professional		$43.34	$61.88	$109.97