Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $57.16 / $57.16 / $146.25	Facility		$57.16	$57.16	$146.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.50 / $53.81 / $89.15	Professional		$36.50	$53.81	$89.15
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $113.31 / $124.64 / $206.22	Facility		$113.31	$124.64	$206.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $105.38 / $105.38 / $139.37	Professional		$105.38	$105.38	$139.37
CareSource Facility/Professional Facility Modifier Low / Median / High Price $81.51 / $135.97 / $242.48	Facility		$81.51	$135.97	$242.48
CareSource Facility/Professional Professional Modifier Low / Median / High Price $113.31 / $118.98 / $158.63	Professional		$113.31	$118.98	$158.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $70.80 / $234.53 / $473.05	Facility		$70.80	$234.53	$473.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.68 / $188.71 / $214.44	Professional		$51.68	$188.71	$214.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.50 / $85.74 / $130.31	Facility		$36.50	$85.74	$130.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $64.88 / $113.31 / $135.97	Professional		$64.88	$113.31	$135.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.16 / $113.31 / $589.07	Facility		$57.16	$113.31	$589.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.33 / $67.98 / $123.38	Professional		$51.33	$67.98	$123.38
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 $36.50 / $85.74 / $130.31	Facility		$36.50	$85.74	$130.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $64.88 / $113.31 / $135.97	Professional		$64.88	$113.31	$135.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $113.31 / $174.37 / $339.25	Professional		$113.31	$174.37	$339.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $70.80 / $221.30 / $589.07	Facility		$70.80	$221.30	$589.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.68 / $70.80 / $736.54	Professional		$51.68	$70.80	$736.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $113.31 / $113.31 / $113.31	Professional		$113.31	$113.31	$113.31
Security Health Facility/Professional Professional Modifier Low / Median / High Price $90.38 / $113.31 / $113.31	Professional		$90.38	$113.31	$113.31
United Facility/Professional Professional Modifier Low / Median / High Price $45.14 / $62.76 / $108.34	Professional		$45.14	$62.76	$108.34