Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $62.43 / $62.43 / $62.43	Facility		$62.43	$62.43	$62.43
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.90 / $62.43 / $103.66	Professional		$45.90	$62.43	$103.66
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $123.76 / $136.13 / $225.24	Facility		$123.76	$136.13	$225.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $111.38 / $115.10 / $152.22	Professional		$111.38	$115.10	$152.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $89.03 / $264.85 / $264.85	Facility		$89.03	$264.85	$264.85
Cigna Facility/Professional Facility Modifier Low / Median / High Price $68.84 / $256.08 / $516.44	Facility		$68.84	$256.08	$516.44
Cigna Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $206.12 / $234.23	Professional		$50.25	$206.12	$234.23
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $35.47 / $93.65 / $142.32	Facility		$35.47	$93.65	$142.32
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $70.86 / $123.76 / $148.51	Professional		$70.86	$123.76	$148.51
Medica Facility/Professional Facility Modifier Low / Median / High Price $61.42 / $123.76 / $584.39	Facility		$61.42	$123.76	$584.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $55.75 / $82.68 / $137.40	Professional		$55.75	$82.68	$137.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.25 / $58.40 / $85.00	Professional		$30.25	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $35.47 / $94.12 / $142.32	Facility		$35.47	$94.12	$142.32
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $70.86 / $123.76 / $148.51	Professional		$70.86	$123.76	$148.51
Quartz Facility/Professional Professional Modifier Low / Median / High Price $123.76 / $190.47 / $330.22	Professional		$123.76	$190.47	$330.22
Quartz Facility/Professional Facility Modifier Low / Median / High Price $68.84 / $241.72 / $584.39	Facility		$68.84	$241.72	$584.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $50.25 / $68.84 / $842.45	Professional		$50.25	$68.84	$842.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $123.76 / $123.76 / $123.76	Professional		$123.76	$123.76	$123.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $98.81 / $123.76 / $123.76	Professional		$98.81	$123.76	$123.76
United Facility/Professional Professional Modifier Low / Median / High Price $45.80 / $73.28 / $106.14	Professional		$45.80	$73.28	$106.14