Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $73.84 / $73.84 / $73.84	Facility		$73.84	$73.84	$73.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $69.89 / $73.84 / $132.72	Professional		$69.89	$73.84	$132.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $146.37 / $161.01 / $266.39	Facility		$146.37	$161.01	$266.39
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.12 / $136.12 / $180.03	Professional		$136.12	$136.12	$180.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $105.31 / $313.23 / $313.23	Facility		$105.31	$313.23	$313.23
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $303.01 / $611.61	Facility		$81.70	$303.01	$611.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $211.88 / $277.01	Professional		$59.64	$211.88	$277.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.11 / $110.76 / $168.33	Facility		$42.11	$110.76	$168.33
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $83.82 / $142.83 / $175.64	Professional		$83.82	$142.83	$175.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.89 / $146.37 / $681.55	Facility		$72.89	$146.37	$681.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $63.91 / $76.68 / $159.38	Professional		$63.91	$76.68	$159.38
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 $42.11 / $110.76 / $168.33	Facility		$42.11	$110.76	$168.33
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $83.82 / $142.83 / $175.64	Professional		$83.82	$142.83	$175.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $146.37 / $225.26 / $391.44	Professional		$146.37	$225.26	$391.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $81.70 / $285.88 / $681.55	Facility		$81.70	$285.88	$681.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.64 / $81.70 / $737.14	Professional		$59.64	$81.70	$737.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $146.37 / $146.37 / $146.37	Professional		$146.37	$146.37	$146.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $116.88 / $146.37 / $146.37	Professional		$116.88	$146.37	$146.37
United Facility/Professional Professional Modifier Low / Median / High Price $54.36 / $73.03 / $141.72	Professional		$54.36	$73.03	$141.72