Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.11 / $54.11 / $54.11	Facility		$54.11	$54.11	$54.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $51.23 / $54.11 / $97.28	Professional		$51.23	$54.11	$97.28
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $107.26 / $117.99 / $195.21	Facility		$107.26	$117.99	$195.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $96.53 / $99.75 / $131.91	Professional		$96.53	$99.75	$131.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $77.17 / $229.54 / $229.54	Facility		$77.17	$229.54	$229.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.89 / $236.42 / $447.86	Facility		$59.89	$236.42	$447.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.72 / $155.63 / $203.00	Professional		$43.72	$155.63	$203.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.87 / $81.17 / $123.35	Facility		$30.87	$81.17	$123.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.42 / $104.71 / $128.71	Professional		$61.42	$104.71	$128.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.42 / $107.26 / $499.54	Facility		$53.42	$107.26	$499.54
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.84 / $56.19 / $116.80	Professional		$46.84	$56.19	$116.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.55 / $58.40 / $85.00	Professional		$47.55	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $30.87 / $81.17 / $123.35	Facility		$30.87	$81.17	$123.35
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $61.42 / $104.71 / $128.71	Professional		$61.42	$104.71	$128.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $107.26 / $165.07 / $287.06	Professional		$107.26	$165.07	$287.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $59.89 / $209.50 / $499.54	Facility		$59.89	$209.50	$499.54
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.72 / $59.89 / $540.03	Professional		$43.72	$59.89	$540.03
Security Health Facility/Professional Professional Modifier Low / Median / High Price $107.26 / $107.26 / $107.26	Professional		$107.26	$107.26	$107.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $85.65 / $107.26 / $107.26	Professional		$85.65	$107.26	$107.26
United Facility/Professional Professional Modifier Low / Median / High Price $37.44 / $53.51 / $95.11	Professional		$37.44	$53.51	$95.11