Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.14 / $58.14 / $58.14	Facility		$58.14	$58.14	$58.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.05 / $58.14 / $80.08	Professional		$41.05	$58.14	$80.08
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.26 / $126.79 / $209.77	Facility		$115.26	$126.79	$209.77
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.68 / $107.19 / $141.76	Professional		$99.68	$107.19	$141.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $82.92 / $246.66 / $246.66	Facility		$82.92	$246.66	$246.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.02 / $238.26 / $481.45	Facility		$54.02	$238.26	$481.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.43 / $191.95 / $218.13	Professional		$39.43	$191.95	$218.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.84 / $87.21 / $132.55	Facility		$27.84	$87.21	$132.55
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $65.98 / $115.26 / $138.31	Professional		$65.98	$115.26	$138.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.19 / $114.80 / $458.27	Facility		$48.19	$114.80	$458.27
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.74 / $57.50 / $125.50	Professional		$42.74	$57.50	$125.50
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 $27.84 / $87.21 / $132.55	Facility		$27.84	$87.21	$132.55
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $65.98 / $115.26 / $138.31	Professional		$65.98	$115.26	$138.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.26 / $172.89 / $258.95	Professional		$115.26	$172.89	$258.95
Quartz Facility/Professional Facility Modifier Low / Median / High Price $54.02 / $225.10 / $458.27	Facility		$54.02	$225.10	$458.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.43 / $54.02 / $890.19	Professional		$39.43	$54.02	$890.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $115.26 / $115.26 / $115.26	Professional		$115.26	$115.26	$115.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.04 / $115.26 / $115.26	Professional		$92.04	$115.26	$115.26
United Facility/Professional Facility Modifier Low / Median / High Price $138.31 / $138.31 / $138.31	Facility		$138.31	$138.31	$138.31
United Facility/Professional Professional Modifier Low / Median / High Price $38.33 / $57.50 / $110.20	Professional		$38.33	$57.50	$110.20