Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.59 / $38.59 / $38.59	Facility		$38.59	$38.59	$38.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.59 / $42.10 / $53.56	Professional		$38.59	$42.10	$53.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $66.48 / $73.13 / $120.99	Facility		$66.48	$73.13	$120.99
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.83 / $61.83 / $81.77	Professional		$59.83	$61.83	$81.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.83 / $142.27 / $142.27	Facility		$47.83	$142.27	$142.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.94 / $178.42 / $277.11	Facility		$39.94	$178.42	$277.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $98.11 / $125.81	Professional		$33.95	$98.11	$125.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $55.68 / $76.45	Facility		$18.20	$55.68	$76.45
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $38.06 / $66.48 / $79.78	Professional		$38.06	$66.48	$79.78
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.35 / $69.45 / $312.25	Facility		$32.35	$69.45	$312.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.49 / $33.17 / $72.38	Professional		$26.49	$33.17	$72.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.73 / $55.00 / $85.00	Professional		$28.73	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.20 / $57.89 / $76.45	Facility		$18.20	$57.89	$76.45
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $38.06 / $66.48 / $79.78	Professional		$38.06	$66.48	$79.78
Quartz Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $102.33 / $169.63	Professional		$66.48	$102.33	$169.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $39.94 / $129.84 / $312.25	Facility		$39.94	$129.84	$312.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.95 / $39.94 / $331.07	Professional		$33.95	$39.94	$331.07
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $66.48 / $66.48	Professional		$66.48	$66.48	$66.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $66.48 / $66.48 / $66.48	Professional		$66.48	$66.48	$66.48
United Facility/Professional Professional Modifier Low / Median / High Price $22.11 / $33.17 / $70.48	Professional		$22.11	$33.17	$70.48