Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.66 / $72.66 / $72.66	Facility		$72.66	$72.66	$72.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $65.64 / $72.66 / $132.44	Professional		$65.64	$72.66	$132.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.04 / $158.44 / $262.14	Facility		$144.04	$158.44	$262.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $133.96 / $133.96 / $177.16	Professional		$133.96	$133.96	$177.16
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.63 / $308.25 / $308.25	Facility		$103.63	$308.25	$308.25
Cigna Facility/Professional Facility Modifier Low / Median / High Price $99.25 / $297.39 / $601.80	Facility		$99.25	$297.39	$601.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $239.89 / $272.60	Professional		$72.45	$239.89	$272.60
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.32 / $108.99 / $165.65	Facility		$40.32	$108.99	$165.65
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $82.47 / $144.04 / $172.85	Professional		$82.47	$144.04	$172.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $69.80 / $144.04 / $682.16	Facility		$69.80	$144.04	$682.16
Medica Facility/Professional Professional Modifier Low / Median / High Price $64.88 / $94.08 / $156.84	Professional		$64.88	$94.08	$156.84
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 $40.32 / $108.99 / $165.65	Facility		$40.32	$108.99	$165.65
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $82.47 / $144.04 / $172.85	Professional		$82.47	$144.04	$172.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.04 / $221.69 / $374.38	Professional		$144.04	$221.69	$374.38
Quartz Facility/Professional Facility Modifier Low / Median / High Price $99.25 / $281.32 / $682.16	Facility		$99.25	$281.32	$682.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.45 / $99.25 / $790.32	Professional		$72.45	$99.25	$790.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $144.04 / $144.04 / $144.04	Professional		$144.04	$144.04	$144.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $144.04 / $144.04 / $144.04	Professional		$144.04	$144.04	$144.04
United Facility/Professional Facility Modifier Low / Median / High Price $0.10 / $93.99 / $94.11	Facility		$0.10	$93.99	$94.11
United Facility/Professional Professional Modifier Low / Median / High Price $48.90 / $86.42 / $127.71	Professional		$48.90	$86.42	$127.71