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 $104.21 / $107.68 / $142.41	Professional		$104.21	$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 $70.70 / $244.45 / $482.85	Facility		$70.70	$244.45	$482.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.62 / $167.81 / $219.15	Professional		$51.62	$167.81	$219.15
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $48.17 / $87.62 / $133.16	Facility		$48.17	$87.62	$133.16
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $113.11 / $115.79 / $138.94	Professional		$113.11	$115.79	$138.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.41 / $115.79 / $539.41	Facility		$58.41	$115.79	$539.41
Medica Facility/Professional Professional Modifier Low / Median / High Price $52.64 / $61.40 / $129.06	Professional		$52.64	$61.40	$129.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.28 / $55.00 / $85.00	Professional		$43.28	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $58.41 / $87.62 / $133.16	Facility		$58.41	$87.62	$133.16
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $113.11 / $115.79 / $138.94	Professional		$113.11	$115.79	$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 $67.33 / $226.16 / $539.41	Facility		$67.33	$226.16	$539.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $51.62 / $70.70 / $583.01	Professional		$51.62	$70.70	$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 $115.79 / $115.79 / $115.79	Professional		$115.79	$115.79	$115.79
United Facility/Professional Professional Modifier Low / Median / High Price $43.02 / $57.77 / $110.72	Professional		$43.02	$57.77	$110.72