Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.15 / $45.15 / $45.15	Facility		$45.15	$45.15	$45.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.15 / $66.98 / $95.66	Professional		$45.15	$66.98	$95.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.45 / $84.10 / $139.13	Facility		$76.45	$84.10	$139.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $71.09 / $71.09 / $95.56	Professional		$71.09	$71.09	$95.56
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.45 / $91.74 / $163.60	Facility		$76.45	$91.74	$163.60
CareSource Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $80.27 / $116.83	Professional		$76.45	$80.27	$116.83
Cigna Facility/Professional Facility Modifier Low / Median / High Price $84.97 / $245.78 / $312.10	Facility		$84.97	$245.78	$312.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $62.03 / $110.97 / $143.84	Professional		$62.03	$110.97	$143.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.15 / $67.73 / $91.74	Facility		$45.15	$67.73	$91.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $68.28 / $76.45 / $91.74	Professional		$68.28	$76.45	$91.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.72 / $81.27 / $370.47	Facility		$49.72	$81.27	$370.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.35 / $66.44 / $134.86	Professional		$55.35	$66.44	$134.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $63.59 / $85.00	Professional		$50.00	$63.59	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $45.15 / $67.73 / $91.74	Facility		$45.15	$67.73	$91.74
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $68.28 / $76.45 / $91.74	Professional		$68.28	$76.45	$91.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.45 / $155.54 / $202.75	Professional		$76.45	$155.54	$202.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $84.97 / $148.44 / $370.47	Facility		$84.97	$148.44	$370.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.03 / $84.97 / $518.09	Professional		$62.03	$84.97	$518.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $103.74 / $103.74 / $103.74	Professional		$103.74	$103.74	$103.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $103.74 / $103.74 / $103.74	Professional		$103.74	$103.74	$103.74
United Facility/Professional Professional Modifier Low / Median / High Price $46.13 / $61.88 / $103.74	Professional		$46.13	$61.88	$103.74