Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.95 / $46.95 / $69.52	Facility		$46.95	$46.95	$69.52
Aetna Facility/Professional Professional Modifier Low / Median / High Price $44.44 / $49.85 / $87.50	Professional		$44.44	$49.85	$87.50
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $93.06 / $102.37 / $169.37	Facility		$93.06	$102.37	$169.37
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.89 / $86.55 / $114.46	Professional		$77.89	$86.55	$114.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.95 / $199.15 / $199.15	Facility		$66.95	$199.15	$199.15
Cigna Facility/Professional Facility Modifier Low / Median / High Price $56.56 / $192.30 / $389.08	Facility		$56.56	$192.30	$389.08
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.29 / $135.00 / $176.13	Professional		$41.29	$135.00	$176.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.73 / $70.43 / $107.02	Facility		$26.73	$70.43	$107.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $53.30 / $89.34 / $111.67	Professional		$53.30	$89.34	$111.67
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.27 / $93.06 / $432.48	Facility		$46.27	$93.06	$432.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.63 / $48.76 / $101.34	Professional		$40.63	$48.76	$101.34
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $55.00 / $85.00	Professional		$43.65	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.73 / $70.43 / $107.02	Facility		$26.73	$70.43	$107.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $53.30 / $89.34 / $111.67	Professional		$53.30	$89.34	$111.67
Quartz Facility/Professional Professional Modifier Low / Median / High Price $93.06 / $143.25 / $248.92	Professional		$93.06	$143.25	$248.92
Quartz Facility/Professional Facility Modifier Low / Median / High Price $56.56 / $181.76 / $432.48	Facility		$56.56	$181.76	$432.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.29 / $56.56 / $463.22	Professional		$41.29	$56.56	$463.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.06 / $93.06 / $93.06	Professional		$93.06	$93.06	$93.06
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.06 / $93.06 / $93.06	Professional		$93.06	$93.06	$93.06
United Facility/Professional Professional Modifier Low / Median / High Price $37.08 / $46.43 / $93.06	Professional		$37.08	$46.43	$93.06