Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.99 / $52.99 / $52.99	Facility		$52.99	$52.99	$52.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $50.16 / $52.99 / $95.26	Professional		$50.16	$52.99	$95.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.04 / $115.54 / $191.17	Facility		$105.04	$115.54	$191.17
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $94.53 / $97.69 / $129.19	Professional		$94.53	$97.69	$129.19
CareSource Facility/Professional Facility Modifier Low / Median / High Price $75.56 / $224.79 / $224.79	Facility		$75.56	$224.79	$224.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $67.95 / $217.64 / $438.06	Facility		$67.95	$217.64	$438.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.61 / $152.34 / $198.80	Professional		$49.61	$152.34	$198.80
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.22 / $79.48 / $120.80	Facility		$30.22	$79.48	$120.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $60.15 / $102.52 / $126.05	Professional		$60.15	$102.52	$126.05
Medica Facility/Professional Facility Modifier Low / Median / High Price $52.32 / $105.04 / $489.15	Facility		$52.32	$105.04	$489.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $45.88 / $55.03 / $114.38	Professional		$45.88	$55.03	$114.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $61.57 / $85.00	Professional		$50.00	$61.57	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $30.22 / $79.48 / $120.80	Facility		$30.22	$79.48	$120.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $60.15 / $102.52 / $126.05	Professional		$60.15	$102.52	$126.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $105.04 / $161.66 / $281.04	Professional		$105.04	$161.66	$281.04
Quartz Facility/Professional Facility Modifier Low / Median / High Price $67.95 / $205.16 / $489.15	Facility		$67.95	$205.16	$489.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.61 / $67.95 / $528.83	Professional		$49.61	$67.95	$528.83
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.04 / $105.04 / $105.04	Professional		$105.04	$105.04	$105.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $83.89 / $105.04 / $105.04	Professional		$83.89	$105.04	$105.04
United Facility/Professional Professional Modifier Low / Median / High Price $39.01 / $52.41 / $93.13	Professional		$39.01	$52.41	$93.13