Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.72 / $61.72 / $61.72	Facility		$61.72	$61.72	$61.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $57.09 / $61.72 / $108.43	Professional		$57.09	$61.72	$108.43
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $122.36 / $134.60 / $222.70	Facility		$122.36	$134.60	$222.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $110.12 / $113.79 / $150.50	Professional		$110.12	$113.79	$150.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $88.02 / $261.85 / $261.85	Facility		$88.02	$261.85	$261.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.43 / $253.30 / $510.84	Facility		$73.43	$253.30	$510.84
Cigna Facility/Professional Professional Modifier Low / Median / High Price $53.60 / $177.19 / $231.58	Professional		$53.60	$177.19	$231.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $37.85 / $92.58 / $140.71	Facility		$37.85	$92.58	$140.71
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $70.06 / $122.36 / $156.68	Professional		$70.06	$122.36	$156.68
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.72 / $128.47 / $621.04	Facility		$61.72	$128.47	$621.04
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.20 / $68.40 / $138.13	Professional		$54.20	$68.40	$138.13
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 $37.85 / $92.58 / $140.71	Facility		$37.85	$92.58	$140.71
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $70.06 / $122.36 / $156.68	Professional		$70.06	$122.36	$156.68
Quartz Facility/Professional Professional Modifier Low / Median / High Price $122.36 / $188.29 / $351.30	Professional		$122.36	$188.29	$351.30
Quartz Facility/Professional Facility Modifier Low / Median / High Price $73.43 / $238.98 / $621.04	Facility		$73.43	$238.98	$621.04
Quartz Facility/Professional Professional Modifier Low / Median / High Price $53.60 / $73.43 / $775.57	Professional		$53.60	$73.43	$775.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $122.36 / $122.36 / $122.36	Professional		$122.36	$122.36	$122.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $122.36 / $122.36 / $122.36	Professional		$122.36	$122.36	$122.36
United Facility/Professional Professional Modifier Low / Median / High Price $48.75 / $65.08 / $117.00	Professional		$48.75	$65.08	$117.00