Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $69.92 / $69.92 / $69.92	Facility		$69.92	$69.92	$69.92
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.81 / $69.92 / $125.00	Professional		$65.81	$69.92	$125.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $138.60 / $152.46 / $252.25	Facility		$138.60	$152.46	$252.25
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $124.74 / $128.90 / $170.47	Professional		$124.74	$128.90	$170.47
CareSource Facility/Professional Facility Modifier Low / Median / High Price $99.70 / $296.60 / $296.60	Facility		$99.70	$296.60	$296.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $89.65 / $286.13 / $578.02	Facility		$89.65	$286.13	$578.02
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.44 / $200.63 / $262.31	Professional		$65.44	$200.63	$262.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $44.64 / $104.88 / $159.38	Facility		$44.64	$104.88	$159.38
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $79.34 / $138.60 / $184.79	Professional		$79.34	$138.60	$184.79
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.92 / $145.09 / $737.38	Facility		$69.92	$145.09	$737.38
Medica Facility/Professional Professional Modifier Low / Median / High Price $62.78 / $80.67 / $156.47	Professional		$62.78	$80.67	$156.47
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 $44.64 / $104.88 / $159.38	Facility		$44.64	$104.88	$159.38
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $79.34 / $138.60 / $184.79	Professional		$79.34	$138.60	$184.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $138.60 / $213.31 / $414.53	Professional		$138.60	$213.31	$414.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $89.65 / $270.70 / $737.38	Facility		$89.65	$270.70	$737.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.44 / $89.65 / $1,373.31	Professional		$65.44	$89.65	$1,373.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $138.60 / $138.60 / $138.60	Professional		$138.60	$138.60	$138.60
Security Health Facility/Professional Professional Modifier Low / Median / High Price $138.60 / $138.60 / $138.60	Professional		$138.60	$138.60	$138.60
United Facility/Professional Professional Modifier Low / Median / High Price $54.14 / $79.91 / $129.52	Professional		$54.14	$79.91	$129.52