Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $49.48 / $56.90 / $56.90	Facility		$49.48	$56.90	$56.90
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.83 / $49.48 / $88.94	Professional		$46.83	$49.48	$88.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $98.09 / $107.90 / $178.52	Facility		$98.09	$107.90	$178.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.83 / $91.22 / $120.65	Professional		$84.83	$91.22	$120.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $70.56 / $209.91 / $209.91	Facility		$70.56	$209.91	$209.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.48 / $216.39 / $410.07	Facility		$70.48	$216.39	$410.07
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $142.03 / $185.64	Professional		$51.45	$142.03	$185.64
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.22 / $74.22 / $112.80	Facility		$28.22	$74.22	$112.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $95.72 / $117.71	Professional		$56.16	$95.72	$117.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.84 / $98.09 / $456.72	Facility		$48.84	$98.09	$456.72
Medica Facility/Professional Professional Modifier Low / Median / High Price $42.82 / $51.38 / $106.80	Professional		$42.82	$51.38	$106.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.93 / $58.40 / $85.00	Professional		$28.93	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.22 / $74.22 / $112.80	Facility		$28.22	$74.22	$112.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $56.16 / $95.72 / $117.71	Professional		$56.16	$95.72	$117.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $98.09 / $150.94 / $261.97	Professional		$98.09	$150.94	$261.97
Quartz Facility/Professional Facility Modifier Low / Median / High Price $70.48 / $191.58 / $456.72	Facility		$70.48	$191.58	$456.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.45 / $70.48 / $493.67	Professional		$51.45	$70.48	$493.67
Security Health Facility/Professional Professional Modifier Low / Median / High Price $98.09 / $98.09 / $98.09	Professional		$98.09	$98.09	$98.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $98.09 / $98.09 / $98.09	Professional		$98.09	$98.09	$98.09
United Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $48.94 / $93.46	Professional		$34.22	$48.94	$93.46