Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $78.44 / $78.44 / $78.44	Facility		$78.44	$78.44	$78.44
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.86 / $78.44 / $125.09	Professional		$65.86	$78.44	$125.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $155.49 / $171.04 / $282.99	Facility		$155.49	$171.04	$282.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $139.94 / $144.61 / $191.25	Professional		$139.94	$144.61	$191.25
CareSource Facility/Professional Facility Modifier Low / Median / High Price $111.86 / $332.75 / $332.75	Facility		$111.86	$332.75	$332.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.66 / $321.75 / $649.40	Facility		$86.66	$321.75	$649.40
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.26 / $225.47 / $294.29	Professional		$63.26	$225.47	$294.29
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $44.67 / $117.66 / $178.81	Facility		$44.67	$117.66	$178.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $89.03 / $155.49 / $186.59	Professional		$89.03	$155.49	$186.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $77.33 / $155.49 / $735.04	Facility		$77.33	$155.49	$735.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.97 / $82.31 / $172.98	Professional		$63.97	$82.31	$172.98
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 $44.67 / $117.66 / $178.81	Facility		$44.67	$117.66	$178.81
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $89.03 / $155.49 / $186.59	Professional		$89.03	$155.49	$186.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $155.49 / $239.29 / $415.53	Professional		$155.49	$239.29	$415.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $86.66 / $303.70 / $735.04	Facility		$86.66	$303.70	$735.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.26 / $86.66 / $980.55	Professional		$63.26	$86.66	$980.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $155.49 / $155.49 / $155.49	Professional		$155.49	$155.49	$155.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $124.15 / $155.49 / $155.49	Professional		$124.15	$155.49	$155.49
United Facility/Professional Professional Modifier Low / Median / High Price $57.66 / $77.56 / $147.94	Professional		$57.66	$77.56	$147.94