Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.69 / $46.69 / $46.69	Facility		$46.69	$46.69	$46.69
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.00 / $46.69 / $77.52	Professional		$35.00	$46.69	$77.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.55 / $101.81 / $168.44	Facility		$92.55	$101.81	$168.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.07 / $86.07 / $113.83	Professional		$86.07	$86.07	$113.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.59 / $198.06 / $198.06	Facility		$66.59	$198.06	$198.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.87 / $191.35 / $386.28	Facility		$59.87	$191.35	$386.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.71 / $134.06 / $175.16	Professional		$43.71	$134.06	$175.16
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.06 / $70.04 / $106.43	Facility		$27.06	$70.04	$106.43
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $52.99 / $92.55 / $112.02	Professional		$52.99	$92.55	$112.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.69 / $92.55 / $445.11	Facility		$46.69	$92.55	$445.11
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.92 / $61.84 / $104.49	Professional		$41.92	$61.84	$104.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.77 / $58.40 / $85.00	Professional		$39.77	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.06 / $70.04 / $106.43	Facility		$27.06	$70.04	$106.43
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $52.99 / $92.55 / $112.02	Professional		$52.99	$92.55	$112.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $92.55 / $142.46 / $251.93	Professional		$92.55	$142.46	$251.93
Quartz Facility/Professional Facility Modifier Low / Median / High Price $59.87 / $180.76 / $445.11	Facility		$59.87	$180.76	$445.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.71 / $59.87 / $554.50	Professional		$43.71	$59.87	$554.50
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.55 / $92.55 / $92.55	Professional		$92.55	$92.55	$92.55
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.55 / $92.55 / $92.55	Professional		$92.55	$92.55	$92.55
United Facility/Professional Professional Modifier Low / Median / High Price $36.49 / $55.64 / $82.06	Professional		$36.49	$55.64	$82.06