Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.88 / $82.31 / $211.45	Facility		$62.88	$82.31	$211.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.14 / $62.88 / $208.36	Professional		$40.14	$62.88	$208.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $124.66 / $137.13 / $226.88	Facility		$124.66	$137.13	$226.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $104.33 / $115.93 / $153.33	Professional		$104.33	$115.93	$153.33
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.68 / $149.59 / $266.77	Facility		$89.68	$149.59	$266.77
CareSource Facility/Professional Professional Modifier Low / Median / High Price $124.66 / $130.88 / $221.09	Professional		$124.66	$130.88	$221.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $86.64 / $257.98 / $520.64	Facility		$86.64	$257.98	$520.64
Cigna Facility/Professional Professional Modifier Low / Median / High Price $63.25 / $180.47 / $235.94	Professional		$63.25	$180.47	$235.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.15 / $94.32 / $143.36	Facility		$40.15	$94.32	$143.36
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $71.38 / $124.66 / $166.21	Professional		$71.38	$124.66	$166.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $62.88 / $124.38 / $670.88	Facility		$62.88	$124.38	$670.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $56.47 / $74.80 / $140.75	Professional		$56.47	$74.80	$140.75
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 $40.15 / $94.32 / $143.36	Facility		$40.15	$94.32	$143.36
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $71.38 / $124.66 / $166.21	Professional		$71.38	$124.66	$166.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $124.66 / $191.84 / $373.38	Professional		$124.66	$191.84	$373.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $86.64 / $243.48 / $670.88	Facility		$86.64	$243.48	$670.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.25 / $86.64 / $868.37	Professional		$63.25	$86.64	$868.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $124.66 / $124.66 / $124.66	Professional		$124.66	$124.66	$124.66
Security Health Facility/Professional Professional Modifier Low / Median / High Price $99.54 / $124.66 / $124.66	Professional		$99.54	$124.66	$124.66
United Facility/Professional Professional Modifier Low / Median / High Price $49.67 / $71.88 / $119.20	Professional		$49.67	$71.88	$119.20