Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.64 / $57.08 / $57.08	Facility		$49.64	$57.08	$57.08
Aetna Facility/Professional Professional Modifier Low / Median / High Price $41.79 / $49.64 / $79.36	Professional		$41.79	$49.64	$79.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $98.41 / $108.25 / $179.11	Facility		$98.41	$108.25	$179.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $91.52 / $91.52 / $121.04	Professional		$91.52	$91.52	$121.04
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.79 / $210.60 / $210.60	Facility		$70.79	$210.60	$210.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.90 / $203.57 / $410.07	Facility		$65.90	$203.57	$410.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.11 / $142.50 / $186.24	Professional		$48.11	$142.50	$186.24
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.34 / $74.45 / $113.17	Facility		$28.34	$74.45	$113.17
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $56.34 / $98.41 / $118.09	Professional		$56.34	$98.41	$118.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $49.06 / $98.41 / $473.76	Facility		$49.06	$98.41	$473.76
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.59 / $51.55 / $109.74	Professional		$40.59	$51.55	$109.74
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $63.03 / $85.00	Professional		$50.00	$63.03	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.34 / $74.45 / $113.17	Facility		$28.34	$74.45	$113.17
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $56.34 / $98.41 / $118.09	Professional		$56.34	$98.41	$118.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $98.41 / $151.44 / $262.97	Professional		$98.41	$151.44	$262.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.90 / $192.20 / $473.76	Facility		$65.90	$192.20	$473.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.11 / $65.90 / $700.07	Professional		$48.11	$65.90	$700.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $98.41 / $98.41 / $98.41	Professional		$98.41	$98.41	$98.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $98.41 / $98.41 / $98.41	Professional		$98.41	$98.41	$98.41
United Facility/Professional Professional Modifier Low / Median / High Price $36.58 / $49.09 / $87.24	Professional		$36.58	$49.09	$87.24