Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $79.42 / $79.42 / $79.42	Facility		$79.42	$79.42	$79.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $75.18 / $80.91 / $141.40	Professional		$75.18	$80.91	$141.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $157.43 / $173.17 / $286.52	Facility		$157.43	$173.17	$286.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $136.16 / $146.41 / $193.63	Professional		$136.16	$146.41	$193.63
CareSource Facility/Professional Facility Modifier Low / Median / High Price $113.26 / $336.90 / $336.90	Facility		$113.26	$336.90	$336.90
Cigna Facility/Professional Facility Modifier Low / Median / High Price $88.85 / $325.52 / $657.80	Facility		$88.85	$325.52	$657.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.86 / $228.28 / $297.95	Professional		$64.86	$228.28	$297.95
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $45.29 / $119.13 / $181.04	Facility		$45.29	$119.13	$181.04
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $90.14 / $153.68 / $188.92	Professional		$90.14	$153.68	$188.92
Medica Facility/Professional Facility Modifier Low / Median / High Price $78.41 / $157.43 / $734.34	Facility		$78.41	$157.43	$734.34
Medica Facility/Professional Professional Modifier Low / Median / High Price $68.76 / $83.45 / $171.42	Professional		$68.76	$83.45	$171.42
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $102.52	Professional		$50.00	$65.00	$102.52
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $45.29 / $119.13 / $181.04	Facility		$45.29	$119.13	$181.04
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $90.14 / $153.68 / $188.92	Professional		$90.14	$153.68	$188.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $157.43 / $242.28 / $420.55	Professional		$157.43	$242.28	$420.55
Quartz Facility/Professional Facility Modifier Low / Median / High Price $88.85 / $307.48 / $734.34	Facility		$88.85	$307.48	$734.34
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.86 / $88.85 / $792.37	Professional		$64.86	$88.85	$792.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $157.43 / $157.43 / $157.43	Professional		$157.43	$157.43	$157.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $125.70 / $157.43 / $157.43	Professional		$125.70	$157.43	$157.43
United Facility/Professional Professional Modifier Low / Median / High Price $54.94 / $78.54 / $157.43	Professional		$54.94	$78.54	$157.43