Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $45.80 / $45.80 / $45.80	Facility		$45.80	$45.80	$45.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $45.80 / $76.72	Professional		$38.02	$45.80	$76.72
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $90.80 / $99.88 / $165.26	Facility		$90.80	$99.88	$165.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.44 / $84.44 / $111.68	Professional		$84.44	$84.44	$111.68
CareSource Facility/Professional Facility Modifier Low / Median / High Price $65.31 / $194.31 / $194.31	Facility		$65.31	$194.31	$194.31
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.66 / $187.62 / $379.28	Facility		$50.66	$187.62	$379.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.97 / $131.72 / $171.84	Professional		$36.97	$131.72	$171.84
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $26.11 / $68.70 / $104.42	Facility		$26.11	$68.70	$104.42
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $51.98 / $88.62 / $108.96	Professional		$51.98	$88.62	$108.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $45.20 / $90.80 / $423.35	Facility		$45.20	$90.80	$423.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $40.99 / $60.66 / $99.37	Professional		$40.99	$60.66	$99.37
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.47 / $59.11 / $85.00	Professional		$48.47	$59.11	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $26.11 / $68.70 / $104.42	Facility		$26.11	$68.70	$104.42
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $51.98 / $88.62 / $108.96	Professional		$51.98	$88.62	$108.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $90.80 / $139.72 / $242.90	Professional		$90.80	$139.72	$242.90
Quartz Facility/Professional Facility Modifier Low / Median / High Price $50.66 / $177.34 / $423.35	Facility		$50.66	$177.34	$423.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.97 / $50.66 / $456.96	Professional		$36.97	$50.66	$456.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $90.80 / $90.80 / $90.80	Professional		$90.80	$90.80	$90.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.50 / $90.80 / $90.80	Professional		$72.50	$90.80	$90.80
United Facility/Professional Professional Modifier Low / Median / High Price $36.17 / $54.48 / $77.87	Professional		$36.17	$54.48	$77.87