Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $22.86 / $51.26 / $92.22	Facility		$22.86	$51.26	$92.22
Aetna Facility/Professional Professional Modifier Low / Median / High Price $20.00 / $42.50 / $118.86	Professional		$20.00	$42.50	$118.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $80.39 / $88.43 / $146.31	Facility		$80.39	$88.43	$146.31
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.28 / $74.76 / $98.87	Professional		$67.28	$74.76	$98.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $57.83 / $88.43 / $172.03	Facility		$57.83	$88.43	$172.03
CareSource Facility/Professional Professional Modifier Low / Median / High Price $80.39 / $84.41 / $92.47	Professional		$80.39	$84.41	$92.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $45.70 / $166.03 / $335.90	Facility		$45.70	$166.03	$335.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.36 / $133.88 / $152.15	Professional		$33.36	$133.88	$152.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.28 / $60.43 / $92.45	Facility		$21.28	$60.43	$92.45
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $80.39 / $96.47	Professional		$46.04	$80.39	$96.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.28 / $80.39 / $358.44	Facility		$29.28	$80.39	$358.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.03 / $40.61 / $87.54	Professional		$32.03	$40.61	$87.54
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.86 / $55.00 / $85.00	Professional		$40.86	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.28 / $60.84 / $92.45	Facility		$21.28	$60.84	$92.45
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $46.04 / $80.39 / $96.47	Professional		$46.04	$80.39	$96.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $80.39 / $120.59 / $197.73	Professional		$80.39	$120.59	$197.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $45.70 / $157.02 / $358.44	Facility		$45.70	$157.02	$358.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.36 / $45.70 / $506.84	Professional		$33.36	$45.70	$506.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.39 / $80.39 / $80.39	Professional		$80.39	$80.39	$80.39
Security Health Facility/Professional Professional Modifier Low / Median / High Price $64.20 / $80.39 / $80.39	Professional		$64.20	$80.39	$80.39
United Facility/Professional Professional Modifier Low / Median / High Price $26.74 / $40.11 / $76.88	Professional		$26.74	$40.11	$76.88