Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.97 / $63.97 / $63.97	Facility		$63.97	$63.97	$63.97
Aetna Facility/Professional Professional Modifier Low / Median / High Price $53.12 / $63.97 / $107.18	Professional		$53.12	$63.97	$107.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $126.80 / $139.47 / $230.78	Facility		$126.80	$139.47	$230.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $117.92 / $126.80 / $190.20	Professional		$117.92	$126.80	$190.20
CareSource Facility/Professional Facility Modifier Low / Median / High Price $91.22 / $271.35 / $271.35	Facility		$91.22	$271.35	$271.35
Cigna Facility/Professional Facility Modifier Low / Median / High Price $100.70 / $279.51 / $529.04	Facility		$100.70	$279.51	$529.04
Cigna Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $211.19 / $239.99	Professional		$85.60	$211.19	$239.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.50 / $95.96 / $145.82	Facility		$36.50	$95.96	$145.82
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $72.61 / $123.78 / $152.16	Professional		$72.61	$123.78	$152.16
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.18 / $126.80 / $544.75	Facility		$63.18	$126.80	$544.75
Medica Facility/Professional Professional Modifier Low / Median / High Price $57.92 / $84.73 / $138.07	Professional		$57.92	$84.73	$138.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $240.00	Professional		$50.00	$70.00	$240.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.50 / $95.96 / $145.82	Facility		$36.50	$95.96	$145.82
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $72.61 / $123.78 / $152.16	Professional		$72.61	$123.78	$152.16
Quartz Facility/Professional Professional Modifier Low / Median / High Price $126.80 / $195.13 / $339.25	Professional		$126.80	$195.13	$339.25
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.70 / $247.66 / $544.75	Facility		$100.70	$247.66	$544.75
Quartz Facility/Professional Professional Modifier Low / Median / High Price $85.60 / $100.70 / $639.58	Professional		$85.60	$100.70	$639.58
Security Health Facility/Professional Professional Modifier Low / Median / High Price $126.80 / $126.80 / $126.80	Professional		$126.80	$126.80	$126.80
Security Health Facility/Professional Professional Modifier Low / Median / High Price $126.80 / $126.80 / $126.80	Professional		$126.80	$126.80	$126.80
United Facility/Professional Professional Modifier Low / Median / High Price $50.52 / $76.08 / $108.75	Professional		$50.52	$76.08	$108.75