Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.83 / $44.83 / $192.98	Facility		$44.83	$44.83	$192.98
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.00 / $45.68 / $65.13	Professional		$42.00	$45.68	$65.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $88.87 / $97.76 / $161.74	Facility		$88.87	$97.76	$161.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.65 / $82.65 / $109.31	Professional		$82.65	$82.65	$109.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.93 / $190.18 / $190.18	Facility		$63.93	$190.18	$190.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.02 / $196.35 / $370.88	Facility		$56.02	$196.35	$370.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.89 / $148.02 / $168.20	Professional		$40.89	$148.02	$168.20
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.57 / $66.80 / $102.20	Facility		$25.57	$66.80	$102.20
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $50.88 / $86.72 / $106.64	Professional		$50.88	$86.72	$106.64
Medica Facility/Professional Facility Modifier Low / Median / High Price $44.26 / $88.87 / $413.81	Facility		$44.26	$88.87	$413.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.81 / $47.11 / $96.77	Professional		$38.81	$47.11	$96.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.47 / $59.11 / $85.00	Professional		$48.47	$59.11	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.57 / $67.25 / $102.20	Facility		$25.57	$67.25	$102.20
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $50.88 / $86.72 / $106.64	Professional		$50.88	$86.72	$106.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.87 / $136.76 / $237.88	Professional		$88.87	$136.76	$237.88
Quartz Facility/Professional Facility Modifier Low / Median / High Price $56.02 / $173.58 / $413.81	Facility		$56.02	$173.58	$413.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $40.89 / $56.02 / $447.50	Professional		$40.89	$56.02	$447.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $88.87 / $88.87 / $88.87	Professional		$88.87	$88.87	$88.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $70.95 / $88.87 / $88.87	Professional		$70.95	$88.87	$88.87
United Facility/Professional Professional Modifier Low / Median / High Price $35.40 / $44.33 / $88.87	Professional		$35.40	$44.33	$88.87