Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.37 / $45.37 / $62.98	Facility		$45.37	$45.37	$62.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $56.20 / $131.75	Professional		$42.00	$56.20	$131.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $89.93 / $98.92 / $163.66	Facility		$89.93	$98.92	$163.66
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.77 / $83.63 / $110.61	Professional		$77.77	$83.63	$110.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $64.70 / $107.92 / $192.45	Facility		$64.70	$107.92	$192.45
CareSource Facility/Professional Professional Modifier Low / Median / High Price $89.93 / $94.43 / $129.56	Professional		$89.93	$94.43	$129.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $185.74 / $375.08	Facility		$58.00	$185.74	$375.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $130.31 / $170.21	Professional		$42.34	$130.31	$170.21
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.97 / $67.59 / $103.42	Facility		$28.97	$67.59	$103.42
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $51.50 / $89.93 / $107.92	Professional		$51.50	$89.93	$107.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.37 / $89.93 / $472.21	Facility		$45.37	$89.93	$472.21
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.74 / $53.37 / $97.93	Professional		$40.74	$53.37	$97.93
Molina Facility/Professional Professional Modifier Low / Median / High Price $41.82 / $55.00 / $85.00	Professional		$41.82	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.97 / $68.06 / $103.42	Facility		$28.97	$68.06	$103.42
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $51.50 / $89.93 / $107.92	Professional		$51.50	$89.93	$107.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $89.93 / $138.41 / $268.99	Professional		$89.93	$138.41	$268.99
Quartz Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $175.66 / $472.21	Facility		$58.00	$175.66	$472.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $58.00 / $593.54	Professional		$42.34	$58.00	$593.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $89.93 / $89.93 / $89.93	Professional		$89.93	$89.93	$89.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $71.81 / $89.93 / $89.93	Professional		$71.81	$89.93	$89.93
United Facility/Professional Professional Modifier Low / Median / High Price $35.13 / $44.94 / $84.05	Professional		$35.13	$44.94	$84.05