Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.16 / $30.16 / $79.31	Facility		$30.16	$30.16	$79.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $30.16 / $39.56	Professional		$19.17	$30.16	$39.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $47.78 / $47.78 / $78.84	Facility		$47.78	$47.78	$78.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $44.44 / $47.78 / $54.46	Professional		$44.44	$47.78	$54.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.78 / $71.67 / $102.25	Facility		$47.78	$71.67	$102.25
CareSource Facility/Professional Professional Modifier Low / Median / High Price $50.17 / $59.81 / $110.78	Professional		$50.17	$59.81	$110.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $127.96 / $149.53 / $198.74	Facility		$127.96	$149.53	$198.74
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.69 / $69.38 / $89.90	Professional		$28.69	$69.38	$89.90
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $28.82 / $38.45 / $47.78	Facility		$28.82	$38.45	$47.78
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $35.95 / $47.78	Professional		$35.95	$35.95	$47.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $28.67 / $38.45 / $53.00	Facility		$28.67	$38.45	$53.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.28 / $32.00 / $75.70	Professional		$25.28	$32.00	$75.70
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $69.48 / $85.00	Professional		$50.00	$69.48	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $28.82 / $38.45 / $47.78	Facility		$28.82	$38.45	$47.78
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $35.95 / $35.95 / $47.78	Professional		$35.95	$35.95	$47.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $47.78 / $84.81 / $143.00	Professional		$47.78	$84.81	$143.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $92.78 / $96.99 / $227.17	Facility		$92.78	$96.99	$227.17
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.69 / $208.76 / $241.29	Professional		$28.69	$208.76	$241.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.54 / $56.54 / $56.54	Professional		$56.54	$56.54	$56.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.54 / $56.54 / $56.54	Professional		$56.54	$56.54	$56.54
United Facility/Professional Professional Modifier Low / Median / High Price $22.07 / $28.96 / $49.07	Professional		$22.07	$28.96	$49.07