Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $59.47 / $59.47 / $59.47	Facility		$59.47	$59.47	$59.47
Aetna Facility/Professional Professional Modifier Low / Median / High Price $56.30 / $63.25 / $123.25	Professional		$56.30	$63.25	$123.25
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.89 / $129.68 / $214.56	Facility		$117.89	$129.68	$214.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $106.10 / $109.64 / $145.00	Professional		$106.10	$109.64	$145.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $84.81 / $252.28 / $252.28	Facility		$84.81	$252.28	$252.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $65.81 / $260.47 / $492.65	Facility		$65.81	$260.47	$492.65
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.04 / $170.63 / $223.13	Professional		$48.04	$170.63	$223.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.93 / $88.61 / $135.57	Facility		$33.93	$88.61	$135.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $67.51 / $115.08 / $141.47	Professional		$67.51	$115.08	$141.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.73 / $117.89 / $549.05	Facility		$58.73	$117.89	$549.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $51.49 / $61.75 / $128.37	Professional		$51.49	$61.75	$128.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $55.00 / $85.00	Professional		$35.95	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $33.93 / $89.21 / $135.57	Facility		$33.93	$89.21	$135.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $67.51 / $115.08 / $141.47	Professional		$67.51	$115.08	$141.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $117.89 / $181.44 / $315.16	Professional		$117.89	$181.44	$315.16
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.81 / $230.26 / $549.05	Facility		$65.81	$230.26	$549.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.04 / $65.81 / $593.47	Professional		$48.04	$65.81	$593.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.89 / $117.89 / $117.89	Professional		$117.89	$117.89	$117.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $117.89 / $117.89 / $117.89	Professional		$117.89	$117.89	$117.89
United Facility/Professional Facility Modifier Low / Median / High Price $168.53 / $168.53 / $168.53	Facility		$168.53	$168.53	$168.53
United Facility/Professional Professional Modifier Low / Median / High Price $46.97 / $58.81 / $112.72	Professional		$46.97	$58.81	$112.72