Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.85 / $49.85 / $49.85	Facility		$49.85	$49.85	$49.85
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.46 / $57.49 / $68.66	Professional		$45.46	$57.49	$68.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $98.82 / $108.70 / $179.85	Facility		$98.82	$108.70	$179.85
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.93 / $91.90 / $121.54	Professional		$88.93	$91.90	$121.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $71.08 / $211.47 / $211.47	Facility		$71.08	$211.47	$211.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.81 / $204.51 / $412.87	Facility		$62.81	$204.51	$412.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $142.97 / $187.01	Professional		$45.85	$142.97	$187.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.83 / $74.78 / $113.64	Facility		$30.83	$74.78	$113.64
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $56.56 / $98.82 / $127.64	Professional		$56.56	$98.82	$127.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.85 / $100.35 / $501.46	Facility		$49.85	$100.35	$501.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.15 / $55.72 / $111.52	Professional		$44.15	$55.72	$111.52
Molina Facility/Professional Professional Modifier Low / Median / High Price $46.17 / $56.31 / $85.00	Professional		$46.17	$56.31	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $30.83 / $74.78 / $113.64	Facility		$30.83	$74.78	$113.64
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $56.56 / $98.82 / $127.64	Professional		$56.56	$98.82	$127.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $98.82 / $152.08 / $287.06	Professional		$98.82	$152.08	$287.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $62.81 / $193.00 / $501.46	Facility		$62.81	$193.00	$501.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.85 / $62.81 / $706.59	Professional		$45.85	$62.81	$706.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $98.82 / $98.82 / $98.82	Professional		$98.82	$98.82	$98.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $78.88 / $98.82 / $98.82	Professional		$78.88	$98.82	$98.82
United Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $53.02 / $98.82	Professional		$39.36	$53.02	$98.82