Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.84 / $51.84 / $51.84	Facility		$51.84	$51.84	$51.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.84 / $55.49 / $105.38	Professional		$51.84	$55.49	$105.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.77 / $113.05 / $187.04	Facility		$102.77	$113.05	$187.04
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.88 / $95.58 / $126.40	Professional		$88.88	$95.58	$126.40
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.93 / $219.93 / $219.93	Facility		$73.93	$219.93	$219.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.48 / $212.96 / $428.27	Facility		$61.48	$212.96	$428.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $149.06 / $194.50	Professional		$44.88	$149.06	$194.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $31.69 / $77.76 / $118.19	Facility		$31.69	$77.76	$118.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $58.85 / $98.38 / $123.32	Professional		$58.85	$98.38	$123.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.84 / $102.77 / $503.80	Facility		$51.84	$102.77	$503.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.30 / $57.27 / $111.91	Professional		$46.30	$57.27	$111.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.79 / $59.51 / $85.00	Professional		$48.79	$59.51	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $31.69 / $77.76 / $118.19	Facility		$31.69	$77.76	$118.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $58.85 / $98.38 / $123.32	Professional		$58.85	$98.38	$123.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.77 / $158.16 / $294.08	Professional		$102.77	$158.16	$294.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $61.48 / $200.72 / $503.80	Facility		$61.48	$200.72	$503.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.88 / $61.48 / $558.26	Professional		$44.88	$61.48	$558.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.77 / $102.77 / $102.77	Professional		$102.77	$102.77	$102.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.77 / $102.77 / $102.77	Professional		$102.77	$102.77	$102.77
United Facility/Professional Facility Modifier Low / Median / High Price $29.60 / $29.60 / $29.60	Facility		$29.60	$29.60	$29.60
United Facility/Professional Professional Modifier Low / Median / High Price $40.90 / $54.50 / $91.95	Professional		$40.90	$54.50	$91.95