Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.82 / $86.38 / $86.38	Facility		$35.82	$86.38	$86.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.50 / $87.73 / $166.66	Professional		$42.50	$87.73	$166.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $171.23 / $188.35 / $311.64	Facility		$171.23	$188.35	$311.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $154.10 / $159.24 / $210.61	Professional		$154.10	$159.24	$210.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $123.19 / $188.35 / $366.43	Facility		$123.19	$188.35	$366.43
CareSource Facility/Professional Professional Modifier Low / Median / High Price $171.23 / $179.79 / $204.50	Professional		$171.23	$179.79	$204.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $96.73 / $353.65 / $715.18	Facility		$96.73	$353.65	$715.18
Cigna Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $247.97 / $324.08	Professional		$70.61	$247.97	$324.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $47.05 / $129.57 / $196.91	Facility		$47.05	$129.57	$196.91
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $98.04 / $171.23 / $205.48	Professional		$98.04	$171.23	$205.48
Medica Facility/Professional Facility Modifier Low / Median / High Price $81.44 / $171.23 / $766.63	Facility		$81.44	$171.23	$766.63
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.22 / $86.69 / $186.45	Professional		$68.22	$86.69	$186.45
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 $47.05 / $129.57 / $196.91	Facility		$47.05	$129.57	$196.91
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $98.04 / $171.23 / $205.48	Professional		$98.04	$171.23	$205.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $171.23 / $263.52 / $437.61	Professional		$171.23	$263.52	$437.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $96.73 / $334.44 / $766.63	Facility		$96.73	$334.44	$766.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $96.73 / $855.46	Professional		$70.61	$96.73	$855.46
Security Health Facility/Professional Professional Modifier Low / Median / High Price $171.23 / $171.23 / $171.23	Professional		$171.23	$171.23	$171.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $171.23 / $171.23 / $171.23	Professional		$171.23	$171.23	$171.23
United Facility/Professional Professional Modifier Low / Median / High Price $57.06 / $85.43 / $163.74	Professional		$57.06	$85.43	$163.74