Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.21 / $61.21 / $61.21	Facility		$61.21	$61.21	$61.21
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.07 / $61.21 / $108.39	Professional		$57.07	$61.21	$108.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.33 / $133.46 / $220.82	Facility		$121.33	$133.46	$220.82
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.84 / $112.84 / $149.22	Professional		$112.84	$112.84	$149.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.29 / $259.64 / $259.64	Facility		$87.29	$259.64	$259.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $75.09 / $250.49 / $506.64	Facility		$75.09	$250.49	$506.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.82 / $175.78 / $229.64	Professional		$54.82	$175.78	$229.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $38.70 / $91.82 / $139.53	Facility		$38.70	$91.82	$139.53
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $121.33 / $160.22	Professional		$69.48	$121.33	$160.22
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.21 / $121.33 / $634.55	Facility		$61.21	$121.33	$634.55
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.66 / $69.94 / $137.00	Professional		$54.66	$69.94	$137.00
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 $38.70 / $91.82 / $139.53	Facility		$38.70	$91.82	$139.53
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $121.33 / $160.22	Professional		$69.48	$121.33	$160.22
Quartz Facility/Professional Professional Modifier Low / Median / High Price $121.33 / $186.73 / $359.32	Professional		$121.33	$186.73	$359.32
Quartz Facility/Professional Facility Modifier Low / Median / High Price $75.09 / $236.98 / $634.55	Facility		$75.09	$236.98	$634.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.82 / $75.09 / $868.91	Professional		$54.82	$75.09	$868.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.33 / $121.33 / $121.33	Professional		$121.33	$121.33	$121.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $96.89 / $121.33 / $121.33	Professional		$96.89	$121.33	$121.33
United Facility/Professional Professional Modifier Low / Median / High Price $48.34 / $60.76 / $121.33	Professional		$48.34	$60.76	$121.33