Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.66 / $46.66 / $46.66	Facility		$46.66	$46.66	$46.66
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.95 / $46.66 / $82.63	Professional		$40.95	$46.66	$82.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $92.49 / $101.74 / $168.33	Facility		$92.49	$101.74	$168.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $86.02 / $86.02 / $113.76	Professional		$86.02	$86.02	$113.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $66.54 / $197.93 / $197.93	Facility		$66.54	$197.93	$197.93
Cigna Facility/Professional Facility Modifier Low / Median / High Price $59.82 / $191.35 / $386.28	Facility		$59.82	$191.35	$386.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $134.06 / $175.04	Professional		$43.67	$134.06	$175.04
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.04 / $69.98 / $106.36	Facility		$29.04	$69.98	$106.36
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $52.94 / $92.49 / $120.21	Professional		$52.94	$92.49	$120.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $46.66 / $92.49 / $477.03	Facility		$46.66	$92.49	$477.03
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.00 / $61.78 / $104.39	Professional		$43.00	$61.78	$104.39
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.23 / $58.40 / $85.00	Professional		$43.23	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.04 / $69.98 / $106.36	Facility		$29.04	$69.98	$106.36
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $52.94 / $92.49 / $120.21	Professional		$52.94	$92.49	$120.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $92.49 / $142.33 / $270.00	Professional		$92.49	$142.33	$270.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $59.82 / $180.64 / $477.03	Facility		$59.82	$180.64	$477.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.67 / $59.82 / $629.15	Professional		$43.67	$59.82	$629.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.49 / $92.49 / $92.49	Professional		$92.49	$92.49	$92.49
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.49 / $92.49 / $92.49	Professional		$92.49	$92.49	$92.49
United Facility/Professional Facility Modifier Low / Median / High Price $144.25 / $144.25 / $144.25	Facility		$144.25	$144.25	$144.25
United Facility/Professional Professional Modifier Low / Median / High Price $37.49 / $55.49 / $82.00	Professional		$37.49	$55.49	$82.00