Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $55.87 / $55.87 / $55.87	Facility		$55.87	$55.87	$55.87
Aetna Facility/Professional Professional Modifier Low / Median / High Price $46.41 / $55.87 / $93.65	Professional		$46.41	$55.87	$93.65
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $110.76 / $121.84 / $201.58	Facility		$110.76	$121.84	$201.58
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $99.68 / $103.01 / $136.22	Professional		$99.68	$103.01	$136.22
CareSource Facility/Professional Facility Modifier Low / Median / High Price $79.68 / $237.03 / $237.03	Facility		$79.68	$237.03	$237.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $87.96 / $244.45 / $461.86	Facility		$87.96	$244.45	$461.86
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.77 / $162.88 / $209.61	Professional		$74.77	$162.88	$209.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $31.87 / $83.81 / $127.37	Facility		$31.87	$83.81	$127.37
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $63.42 / $108.11 / $132.91	Professional		$63.42	$108.11	$132.91
Medica Facility/Professional Facility Modifier Low / Median / High Price $55.18 / $110.76 / $475.86	Facility		$55.18	$110.76	$475.86
Medica Facility/Professional Professional Modifier Low / Median / High Price $50.59 / $74.01 / $120.60	Professional		$50.59	$74.01	$120.60
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 $31.87 / $83.81 / $127.37	Facility		$31.87	$83.81	$127.37
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $63.42 / $108.11 / $132.91	Professional		$63.42	$108.11	$132.91
Quartz Facility/Professional Professional Modifier Low / Median / High Price $110.76 / $170.44 / $296.08	Professional		$110.76	$170.44	$296.08
Quartz Facility/Professional Facility Modifier Low / Median / High Price $87.96 / $216.32 / $475.86	Facility		$87.96	$216.32	$475.86
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.77 / $87.96 / $558.71	Professional		$74.77	$87.96	$558.71
Security Health Facility/Professional Professional Modifier Low / Median / High Price $110.76 / $110.76 / $110.76	Professional		$110.76	$110.76	$110.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $110.76 / $110.76 / $110.76	Professional		$110.76	$110.76	$110.76
United Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $58.73 / $94.99	Professional		$38.65	$58.73	$94.99