Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.40 / $70.40 / $70.40	Facility		$70.40	$70.40	$70.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.40 / $87.67 / $167.82	Professional		$70.40	$87.67	$167.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $139.56 / $153.52 / $254.00	Facility		$139.56	$153.52	$254.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $125.60 / $129.79 / $171.65	Professional		$125.60	$129.79	$171.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $100.39 / $298.66 / $298.66	Facility		$100.39	$298.66	$298.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.28 / $288.93 / $582.22	Facility		$90.28	$288.93	$582.22
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.90 / $202.03 / $264.13	Professional		$65.90	$202.03	$264.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $44.95 / $105.60 / $160.49	Facility		$44.95	$105.60	$160.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $79.90 / $139.56 / $167.47	Professional		$79.90	$139.56	$167.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.40 / $139.37 / $703.87	Facility		$70.40	$139.37	$703.87
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.22 / $81.23 / $151.96	Professional		$63.22	$81.23	$151.96
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 $44.95 / $105.60 / $160.49	Facility		$44.95	$105.60	$160.49
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $79.90 / $139.56 / $167.47	Professional		$79.90	$139.56	$167.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $139.56 / $214.78 / $417.54	Professional		$139.56	$214.78	$417.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $90.28 / $272.58 / $703.87	Facility		$90.28	$272.58	$703.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.90 / $90.28 / $831.20	Professional		$65.90	$90.28	$831.20
Security Health Facility/Professional Professional Modifier Low / Median / High Price $139.56 / $139.56 / $139.56	Professional		$139.56	$139.56	$139.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $139.56 / $139.56 / $139.56	Professional		$139.56	$139.56	$139.56
United Facility/Professional Professional Modifier Low / Median / High Price $55.60 / $69.62 / $130.41	Professional		$55.60	$69.62	$130.41