Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.86 / $44.86 / $44.86	Facility		$44.86	$44.86	$44.86
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.19 / $44.86 / $68.73	Professional		$36.19	$44.86	$68.73
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $88.92 / $97.81 / $161.83	Facility		$88.92	$97.81	$161.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $80.02 / $82.70 / $109.37	Professional		$80.02	$82.70	$109.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $63.97 / $190.29 / $190.29	Facility		$63.97	$190.29	$190.29
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.54 / $183.88 / $370.88	Facility		$54.54	$183.88	$370.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $128.91 / $168.30	Professional		$39.81	$128.91	$168.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.54 / $67.29 / $102.26	Facility		$24.54	$67.29	$102.26
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $50.92 / $88.92 / $106.70	Professional		$50.92	$88.92	$106.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.49 / $88.92 / $416.19	Facility		$42.49	$88.92	$416.19
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.43 / $45.23 / $96.83	Professional		$35.43	$45.23	$96.83
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.38 / $59.00 / $85.00	Professional		$48.38	$59.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.54 / $67.29 / $102.26	Facility		$24.54	$67.29	$102.26
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $50.92 / $88.92 / $106.70	Professional		$50.92	$88.92	$106.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $88.92 / $136.86 / $227.84	Professional		$88.92	$136.86	$227.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $54.54 / $173.68 / $416.19	Facility		$54.54	$173.68	$416.19
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.81 / $54.54 / $567.17	Professional		$39.81	$54.54	$567.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $88.92 / $88.92 / $88.92	Professional		$88.92	$88.92	$88.92
Security Health Facility/Professional Professional Modifier Low / Median / High Price $71.01 / $88.92 / $88.92	Professional		$71.01	$88.92	$88.92
United Facility/Professional Professional Modifier Low / Median / High Price $31.69 / $44.36 / $88.92	Professional		$31.69	$44.36	$88.92