Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $51.80 / $51.80 / $51.80	Facility		$51.80	$51.80	$51.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.03 / $51.80 / $93.12	Professional		$49.03	$51.80	$93.12
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $102.69 / $112.96 / $186.90	Facility		$102.69	$112.96	$186.90
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $95.50 / $95.50 / $126.30	Professional		$95.50	$95.50	$126.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.88 / $219.76 / $219.76	Facility		$73.88	$219.76	$219.76
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.32 / $226.42 / $428.27	Facility		$57.32	$226.42	$428.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.84 / $171.02 / $194.34	Professional		$41.84	$171.02	$194.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.54 / $77.70 / $118.09	Facility		$29.54	$77.70	$118.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $100.25 / $123.23	Professional		$58.80	$100.25	$123.23
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.14 / $102.69 / $478.20	Facility		$51.14	$102.69	$478.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $44.84 / $53.80 / $111.81	Professional		$44.84	$53.80	$111.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $29.18 / $58.40 / $85.00	Professional		$29.18	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.54 / $77.70 / $118.09	Facility		$29.54	$77.70	$118.09
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $58.80 / $100.25 / $123.23	Professional		$58.80	$100.25	$123.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $102.69 / $158.05 / $275.01	Professional		$102.69	$158.05	$275.01
Quartz Facility/Professional Facility Modifier Low / Median / High Price $57.32 / $200.56 / $478.20	Facility		$57.32	$200.56	$478.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.84 / $57.32 / $516.82	Professional		$41.84	$57.32	$516.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.69 / $102.69 / $102.69	Professional		$102.69	$102.69	$102.69
Security Health Facility/Professional Professional Modifier Low / Median / High Price $82.01 / $102.69 / $102.69	Professional		$82.01	$102.69	$102.69
United Facility/Professional Facility Modifier Low / Median / High Price $146.78 / $146.78 / $146.78	Facility		$146.78	$146.78	$146.78
United Facility/Professional Professional Modifier Low / Median / High Price $38.14 / $51.23 / $91.04	Professional		$38.14	$51.23	$91.04