Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.04 / $59.04 / $59.04	Facility		$59.04	$59.04	$59.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.58 / $59.04 / $105.55	Professional		$55.58	$59.04	$105.55
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.04 / $128.74 / $213.01	Facility		$117.04	$128.74	$213.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $107.05 / $108.85 / $143.94	Professional		$107.05	$108.85	$143.94
CareSource Facility/Professional Facility Modifier Low / Median / High Price $84.20 / $250.47 / $250.47	Facility		$84.20	$250.47	$250.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.70 / $258.48 / $488.45	Facility		$75.70	$258.48	$488.45
Cigna Facility/Professional Professional Modifier Low / Median / High Price $55.27 / $194.93 / $221.51	Professional		$55.27	$194.93	$221.51
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.92 / $88.56 / $134.60	Facility		$33.92	$88.56	$134.60
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $67.01 / $117.04 / $140.44	Professional		$67.01	$117.04	$140.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.72 / $117.04 / $547.75	Facility		$58.72	$117.04	$547.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.83 / $61.31 / $127.44	Professional		$50.83	$61.31	$127.44
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.69 / $60.60 / $85.00	Professional		$49.69	$60.60	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $33.92 / $88.56 / $134.60	Facility		$33.92	$88.56	$134.60
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $67.01 / $117.04 / $140.44	Professional		$67.01	$117.04	$140.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.04 / $180.13 / $315.16	Professional		$117.04	$180.13	$315.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.70 / $228.60 / $547.75	Facility		$75.70	$228.60	$547.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.27 / $75.70 / $582.86	Professional		$55.27	$75.70	$582.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.04 / $117.04 / $117.04	Professional		$117.04	$117.04	$117.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.45 / $117.04 / $117.04	Professional		$93.45	$117.04	$117.04
United Facility/Professional Professional Modifier Low / Median / High Price $46.63 / $58.39 / $117.04	Professional		$46.63	$58.39	$117.04