Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.21 / $62.21 / $62.21	Facility		$62.21	$62.21	$62.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $58.57 / $63.39 / $111.23	Professional		$58.57	$63.39	$111.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.32 / $135.65 / $224.44	Facility		$123.32	$135.65	$224.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.66 / $114.69 / $151.68	Professional		$106.66	$114.69	$151.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $88.71 / $263.89 / $263.89	Facility		$88.71	$263.89	$263.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $79.77 / $255.16 / $515.04	Facility		$79.77	$255.16	$515.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $178.59 / $233.39	Professional		$58.23	$178.59	$233.39
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.72 / $93.32 / $141.82	Facility		$39.72	$93.32	$141.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $123.32 / $164.43	Professional		$70.61	$123.32	$164.43
Medica Facility/Professional Facility Modifier Low / Median / High Price $62.21 / $123.32 / $647.48	Facility		$62.21	$123.32	$647.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.86 / $71.78 / $139.22	Professional		$55.86	$71.78	$139.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $105.90	Professional		$50.00	$65.00	$105.90
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.72 / $93.32 / $141.82	Facility		$39.72	$93.32	$141.82
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $70.61 / $123.32 / $164.43	Professional		$70.61	$123.32	$164.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.32 / $189.79 / $369.36	Professional		$123.32	$189.79	$369.36
Quartz Facility/Professional Facility Modifier Low / Median / High Price $79.77 / $240.86 / $647.48	Facility		$79.77	$240.86	$647.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $79.77 / $918.41	Professional		$58.23	$79.77	$918.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $123.32 / $123.32 / $123.32	Professional		$123.32	$123.32	$123.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $123.32 / $123.32 / $123.32	Professional		$123.32	$123.32	$123.32
United Facility/Professional Professional Modifier Low / Median / High Price $49.13 / $62.35 / $117.92	Professional		$49.13	$62.35	$117.92