Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.39 / $61.39 / $61.39	Facility		$53.39	$61.39	$61.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $52.25 / $58.83 / $98.26	Professional		$52.25	$58.83	$98.26
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $105.84 / $116.42 / $192.63	Facility		$105.84	$116.42	$192.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.25 / $98.43 / $130.18	Professional		$95.25	$98.43	$130.18
CareSource Facility/Professional Facility Modifier Low / Median / High Price $76.14 / $226.50 / $226.50	Facility		$76.14	$226.50	$226.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.45 / $218.57 / $442.26	Facility		$68.45	$218.57	$442.26
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.98 / $153.28 / $200.31	Professional		$49.98	$153.28	$200.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $34.09 / $80.09 / $121.72	Facility		$34.09	$80.09	$121.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $60.60 / $105.84 / $141.12	Professional		$60.60	$105.84	$141.12
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.39 / $105.84 / $594.69	Facility		$53.39	$105.84	$594.69
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.94 / $61.60 / $119.49	Professional		$47.94	$61.60	$119.49
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 $34.09 / $80.09 / $121.72	Facility		$34.09	$80.09	$121.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $60.60 / $105.84 / $141.12	Professional		$60.60	$105.84	$141.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $105.84 / $162.88 / $317.17	Professional		$105.84	$162.88	$317.17
Quartz Facility/Professional Facility Modifier Low / Median / High Price $68.45 / $206.72 / $594.69	Facility		$68.45	$206.72	$594.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.98 / $68.45 / $880.61	Professional		$49.98	$68.45	$880.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $105.84 / $105.84 / $105.84	Professional		$105.84	$105.84	$105.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $84.52 / $105.84 / $105.84	Professional		$84.52	$105.84	$105.84
United Facility/Professional Facility Modifier Low / Median / High Price $169.34 / $169.34 / $169.34	Facility		$169.34	$169.34	$169.34
United Facility/Professional Professional Modifier Low / Median / High Price $42.17 / $53.52 / $105.84	Professional		$42.17	$53.52	$105.84