Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $74.18 / $74.18 / $74.18	Facility		$74.18	$74.18	$74.18
Aetna Facility/Professional Professional Modifier Low / Median / High Price $62.71 / $76.04 / $119.09	Professional		$62.71	$76.04	$119.09
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $147.06 / $161.77 / $267.64	Facility		$147.06	$161.77	$267.64
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $127.19 / $136.77 / $180.88	Professional		$127.19	$136.77	$180.88
CareSource Facility/Professional Facility Modifier Low / Median / High Price $105.80 / $314.70 / $314.70	Facility		$105.80	$314.70	$314.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $92.98 / $303.94 / $614.41	Facility		$92.98	$303.94	$614.41
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.88 / $244.92 / $278.31	Professional		$67.88	$244.92	$278.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.78 / $111.27 / $169.12	Facility		$40.78	$111.27	$169.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $84.22 / $147.06 / $176.47	Professional		$84.22	$147.06	$176.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.59 / $147.06 / $659.83	Facility		$70.59	$147.06	$659.83
Medica Facility/Professional Professional Modifier Low / Median / High Price $58.59 / $75.14 / $160.13	Professional		$58.59	$75.14	$160.13
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.80	Professional		$50.00	$65.00	$85.80
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $40.78 / $111.27 / $169.12	Facility		$40.78	$111.27	$169.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $84.22 / $147.06 / $176.47	Professional		$84.22	$147.06	$176.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $147.06 / $226.33 / $379.40	Professional		$147.06	$226.33	$379.40
Quartz Facility/Professional Facility Modifier Low / Median / High Price $92.98 / $287.22 / $659.83	Facility		$92.98	$287.22	$659.83
Quartz Facility/Professional Professional Modifier Low / Median / High Price $67.88 / $92.98 / $736.96	Professional		$67.88	$92.98	$736.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $147.06 / $147.06 / $147.06	Professional		$147.06	$147.06	$147.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.44 / $147.06 / $147.06	Professional		$117.44	$147.06	$147.06
United Facility/Professional Professional Modifier Low / Median / High Price $49.46 / $73.37 / $135.05	Professional		$49.46	$73.37	$135.05