Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.84 / $57.84 / $57.84	Facility		$57.84	$57.84	$57.84
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.84 / $67.29 / $85.45	Professional		$57.84	$67.29	$85.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $116.34 / $428.76 / $504.43	Professional		$116.34	$428.76	$504.43
CareSource Facility/Professional Facility Modifier Low / Median / High Price $90.79 / $90.79 / $90.79	Facility		$90.79	$90.79	$90.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $139.08 / $415.00 / $580.82	Facility		$139.08	$415.00	$580.82
Cigna Facility/Professional Professional Modifier Low / Median / High Price $101.53 / $225.75 / $282.19	Professional		$101.53	$225.75	$282.19
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $56.24 / $86.76 / $125.93	Facility		$56.24	$86.76	$125.93
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $95.93 / $95.93 / $95.93	Professional		$95.93	$95.93	$95.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.84 / $125.93 / $600.04	Facility		$57.84	$125.93	$600.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $66.43 / $89.17 / $146.12	Professional		$66.43	$89.17	$146.12
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $201.72	Professional		$50.00	$65.00	$201.72
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $56.24 / $86.76 / $125.93	Facility		$56.24	$86.76	$125.93
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $95.93 / $95.93 / $95.93	Professional		$95.93	$95.93	$95.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $145.69 / $267.39 / $347.20	Professional		$145.69	$267.39	$347.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $139.08 / $215.98 / $600.04	Facility		$139.08	$215.98	$600.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $101.53 / $139.08 / $795.07	Professional		$101.53	$139.08	$795.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $218.75 / $252.20 / $257.35	Professional		$218.75	$252.20	$257.35
United Facility/Professional Professional Modifier Low / Median / High Price $57.70 / $85.64 / $130.25	Professional		$57.70	$85.64	$130.25