Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.61 / $48.61 / $48.61	Facility		$48.61	$48.61	$48.61
Aetna Facility/Professional Professional Modifier Low / Median / High Price $26.95 / $48.61 / $70.13	Professional		$26.95	$48.61	$70.13
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.72 / $83.72 / $138.13	Facility		$83.72	$83.72	$138.13
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.86 / $83.72 / $95.44	Professional		$77.86	$83.72	$95.44
CareSource Facility/Professional Facility Modifier Low / Median / High Price $83.72 / $179.16 / $179.16	Facility		$83.72	$179.16	$179.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $225.28 / $263.26 / $349.89	Facility		$225.28	$263.26	$349.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $121.41 / $158.44	Professional		$34.15	$121.41	$158.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $47.02 / $68.98 / $135.74	Facility		$47.02	$68.98	$135.74
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $45.16 / $45.16 / $83.72	Professional		$45.16	$45.16	$83.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.03 / $68.98 / $157.77	Facility		$48.03	$68.98	$157.77
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.63 / $46.05 / $152.59	Professional		$38.63	$46.05	$152.59
Molina Facility/Professional Professional Modifier Low / Median / High Price $48.65 / $58.40 / $85.00	Professional		$48.65	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $47.02 / $68.98 / $135.74	Facility		$47.02	$68.98	$135.74
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $45.16 / $45.16 / $83.72	Professional		$45.16	$45.16	$83.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $83.72 / $125.58 / $220.00	Professional		$83.72	$125.58	$220.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $163.52 / $169.95 / $391.81	Facility		$163.52	$169.95	$391.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.15 / $367.92 / $544.17	Professional		$34.15	$367.92	$544.17
Security Health Facility/Professional Professional Modifier Low / Median / High Price $83.72 / $83.72 / $83.72	Professional		$83.72	$83.72	$83.72
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.56 / $83.72 / $83.72	Professional		$80.56	$83.72	$83.72
United Facility/Professional Professional Modifier Low / Median / High Price $27.84 / $41.77 / $77.54	Professional		$27.84	$41.77	$77.54