Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $72.72 / $72.72 / $72.72	Facility		$72.72	$72.72	$72.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $60.05 / $72.72 / $121.17	Professional		$60.05	$72.72	$121.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $144.13 / $158.55 / $262.33	Facility		$144.13	$158.55	$262.33
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $129.72 / $134.05 / $177.29	Professional		$129.72	$134.05	$177.29
CareSource Facility/Professional Facility Modifier Low / Median / High Price $103.69 / $308.45 / $308.45	Facility		$103.69	$308.45	$308.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $90.07 / $298.31 / $601.80	Facility		$90.07	$298.31	$601.80
Cigna Facility/Professional Professional Modifier Low / Median / High Price $65.75 / $209.06 / $272.79	Professional		$65.75	$209.06	$272.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $46.42 / $109.08 / $165.76	Facility		$46.42	$109.08	$165.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $82.53 / $144.13 / $183.20	Professional		$82.53	$144.13	$183.20
Medica Facility/Professional Facility Modifier Low / Median / High Price $72.72 / $144.13 / $730.36	Facility		$72.72	$144.13	$730.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $67.02 / $96.31 / $162.72	Professional		$67.02	$96.31	$162.72
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 $46.42 / $111.26 / $165.76	Facility		$46.42	$111.26	$165.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $82.53 / $144.13 / $183.20	Professional		$82.53	$144.13	$183.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $144.13 / $221.82 / $431.59	Professional		$144.13	$221.82	$431.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $90.07 / $281.52 / $730.36	Facility		$90.07	$281.52	$730.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.75 / $90.07 / $879.36	Professional		$65.75	$90.07	$879.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $144.13 / $144.13 / $144.13	Professional		$144.13	$144.13	$144.13
Security Health Facility/Professional Professional Modifier Low / Median / High Price $115.09 / $144.13 / $144.13	Professional		$115.09	$144.13	$144.13
United Facility/Professional Professional Modifier Low / Median / High Price $57.43 / $86.48 / $144.13	Professional		$57.43	$86.48	$144.13