Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.38 / $46.38 / $46.38	Facility		$46.38	$46.38	$46.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.91 / $46.38 / $83.39	Professional		$43.91	$46.38	$83.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $91.93 / $101.12 / $167.31	Facility		$91.93	$101.12	$167.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $82.73 / $85.49 / $113.07	Professional		$82.73	$85.49	$113.07
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.14 / $196.73 / $196.73	Facility		$66.14	$196.73	$196.73
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.03 / $203.37 / $383.48	Facility		$57.03	$203.37	$383.48
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.63 / $133.13 / $173.99	Professional		$41.63	$133.13	$173.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.46 / $69.56 / $105.72	Facility		$26.46	$69.56	$105.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $52.63 / $89.75 / $110.32	Professional		$52.63	$89.75	$110.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.79 / $91.93 / $428.17	Facility		$45.79	$91.93	$428.17
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.14 / $48.16 / $100.10	Professional		$40.14	$48.16	$100.10
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.25 / $58.40 / $85.00	Professional		$30.25	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.46 / $69.56 / $105.72	Facility		$26.46	$69.56	$105.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $52.63 / $89.75 / $110.32	Professional		$52.63	$89.75	$110.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $91.93 / $141.49 / $245.91	Professional		$91.93	$141.49	$245.91
Quartz Facility/Professional Facility Modifier Low / Median / High Price $57.03 / $179.56 / $428.17	Facility		$57.03	$179.56	$428.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.63 / $57.03 / $462.74	Professional		$41.63	$57.03	$462.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.93 / $91.93 / $91.93	Professional		$91.93	$91.93	$91.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.93 / $91.93 / $91.93	Professional		$91.93	$91.93	$91.93
United Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $45.86 / $87.62	Professional		$34.15	$45.86	$87.62