Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.90 / $75.00 / $129.88	Facility		$39.90	$75.00	$129.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.50 / $60.49 / $144.50	Professional		$42.50	$60.49	$144.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $116.57 / $128.22 / $212.16	Facility		$116.57	$128.22	$212.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $108.41 / $108.41 / $143.38	Professional		$108.41	$108.41	$143.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.87 / $139.88 / $249.46	Facility		$83.87	$139.88	$249.46
CareSource Facility/Professional Professional Modifier Low / Median / High Price $116.57 / $122.40 / $165.84	Professional		$116.57	$122.40	$165.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.22 / $241.10 / $487.05	Facility		$68.22	$241.10	$487.05
Cigna Facility/Professional Professional Modifier Low / Median / High Price $49.80 / $168.75 / $220.63	Professional		$49.80	$168.75	$220.63
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.44 / $87.63 / $134.06	Facility		$32.44	$87.63	$134.06
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $66.76 / $116.57 / $139.88	Professional		$66.76	$116.57	$139.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $56.14 / $116.57 / $535.05	Facility		$56.14	$116.57	$535.05
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.45 / $59.76 / $126.94	Professional		$46.45	$59.76	$126.94
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 $32.44 / $88.22 / $134.06	Facility		$32.44	$88.22	$134.06
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $66.76 / $116.57 / $139.88	Professional		$66.76	$116.57	$139.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $116.57 / $174.86 / $301.11	Professional		$116.57	$174.86	$301.11
Quartz Facility/Professional Facility Modifier Low / Median / High Price $68.22 / $227.68 / $535.05	Facility		$68.22	$227.68	$535.05
Quartz Facility/Professional Professional Modifier Low / Median / High Price $49.80 / $68.22 / $835.47	Professional		$49.80	$68.22	$835.47
Security Health Facility/Professional Professional Modifier Low / Median / High Price $116.57 / $116.57 / $116.57	Professional		$116.57	$116.57	$116.57
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.10 / $116.57 / $116.57	Professional		$93.10	$116.57	$116.57
United Facility/Professional Professional Modifier Low / Median / High Price $39.34 / $58.16 / $116.57	Professional		$39.34	$58.16	$116.57