Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.64 / $56.64 / $56.64	Facility		$56.64	$56.64	$56.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.14 / $56.64 / $94.05	Professional		$40.14	$56.64	$94.05
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $112.28 / $123.51 / $204.35	Facility		$112.28	$123.51	$204.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.05 / $104.42 / $138.10	Professional		$101.05	$104.42	$138.10
CareSource Facility/Professional Facility Modifier Low / Median / High Price $80.77 / $240.28 / $240.28	Facility		$80.77	$240.28	$240.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $60.21 / $231.70 / $468.85	Facility		$60.21	$231.70	$468.85
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $162.66 / $212.50	Professional		$43.95	$162.66	$212.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $31.03 / $84.96 / $129.12	Facility		$31.03	$84.96	$129.12
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $64.30 / $112.28 / $134.74	Professional		$64.30	$112.28	$134.74
Medica Facility/Professional Facility Modifier Low / Median / High Price $53.72 / $112.28 / $510.07	Facility		$53.72	$112.28	$510.07
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.71 / $72.41 / $122.26	Professional		$48.71	$72.41	$122.26
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.96 / $58.40 / $85.00	Professional		$44.96	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $31.03 / $84.96 / $129.12	Facility		$31.03	$84.96	$129.12
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $64.30 / $112.28 / $134.74	Professional		$64.30	$112.28	$134.74
Quartz Facility/Professional Professional Modifier Low / Median / High Price $112.28 / $172.80 / $288.06	Professional		$112.28	$172.80	$288.06
Quartz Facility/Professional Facility Modifier Low / Median / High Price $60.21 / $219.30 / $510.07	Facility		$60.21	$219.30	$510.07
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.95 / $60.21 / $638.51	Professional		$43.95	$60.21	$638.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.28 / $112.28 / $112.28	Professional		$112.28	$112.28	$112.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $112.28 / $112.28 / $112.28	Professional		$112.28	$112.28	$112.28
United Facility/Professional Professional Modifier Low / Median / High Price $40.06 / $64.09 / $96.30	Professional		$40.06	$64.09	$96.30