Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.07 / $61.07 / $61.07	Facility		$61.07	$61.07	$61.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.79 / $61.07 / $109.76	Professional		$57.79	$61.07	$109.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $121.06 / $133.16 / $220.33	Facility		$121.06	$133.16	$220.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $112.59 / $112.59 / $148.90	Professional		$112.59	$112.59	$148.90
CareSource Facility/Professional Facility Modifier Low / Median / High Price $87.09 / $259.07 / $259.07	Facility		$87.09	$259.07	$259.07
Cigna Facility/Professional Facility Modifier Low / Median / High Price $81.30 / $267.48 / $505.24	Facility		$81.30	$267.48	$505.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $59.35 / $175.31 / $229.11	Professional		$59.35	$175.31	$229.11
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $34.83 / $91.61 / $139.22	Facility		$34.83	$91.61	$139.22
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $69.31 / $118.15 / $145.27	Professional		$69.31	$118.15	$145.27
Medica Facility/Professional Facility Modifier Low / Median / High Price $60.29 / $121.06 / $563.71	Facility		$60.29	$121.06	$563.71
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.86 / $63.42 / $131.81	Professional		$52.86	$63.42	$131.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $34.83 / $91.61 / $139.22	Facility		$34.83	$91.61	$139.22
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $69.31 / $118.15 / $145.27	Professional		$69.31	$118.15	$145.27
Quartz Facility/Professional Professional Modifier Low / Median / High Price $121.06 / $186.32 / $324.20	Professional		$121.06	$186.32	$324.20
Quartz Facility/Professional Facility Modifier Low / Median / High Price $81.30 / $236.44 / $563.71	Facility		$81.30	$236.44	$563.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.35 / $81.30 / $609.50	Professional		$59.35	$81.30	$609.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.06 / $121.06 / $121.06	Professional		$121.06	$121.06	$121.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $121.06 / $121.06 / $121.06	Professional		$121.06	$121.06	$121.06
United Facility/Professional Professional Modifier Low / Median / High Price $44.96 / $60.40 / $107.33	Professional		$44.96	$60.40	$107.33