Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.41 / $58.41 / $58.41	Facility		$58.41	$58.41	$58.41
Aetna Facility/Professional Professional Modifier Low / Median / High Price $55.31 / $59.51 / $104.02	Professional		$55.31	$59.51	$104.02
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $115.79 / $127.37 / $210.74	Facility		$115.79	$127.37	$210.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $103.20 / $107.68 / $142.41	Professional		$103.20	$107.68	$142.41
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.31 / $247.79 / $247.79	Facility		$83.31	$247.79	$247.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.66 / $255.46 / $482.85	Facility		$64.66	$255.46	$482.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $64.66 / $135.59 / $219.15	Professional		$64.66	$135.59	$219.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.32 / $87.03 / $133.16	Facility		$33.32	$87.03	$133.16
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $66.30 / $113.11 / $138.94	Professional		$66.30	$113.11	$138.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $57.68 / $115.79 / $539.41	Facility		$57.68	$115.79	$539.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.58 / $60.66 / $126.08	Professional		$50.58	$60.66	$126.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.79 / $58.40 / $85.00	Professional		$36.79	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $33.32 / $87.62 / $133.16	Facility		$33.32	$87.62	$133.16
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $66.30 / $113.11 / $138.94	Professional		$66.30	$113.11	$138.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $115.79 / $178.19 / $310.14	Professional		$115.79	$178.19	$310.14
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.66 / $226.16 / $539.41	Facility		$64.66	$226.16	$539.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.20 / $64.66 / $583.01	Professional		$47.20	$64.66	$583.01
Security Health Facility/Professional Professional Modifier Low / Median / High Price $115.79 / $115.79 / $115.79	Professional		$115.79	$115.79	$115.79
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.46 / $115.79 / $115.79	Professional		$92.46	$115.79	$115.79
United Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $57.77 / $115.79	Professional		$43.02	$57.77	$115.79