Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.29 / $30.29 / $30.29	Facility		$30.29	$30.29	$30.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.29 / $33.03 / $42.01	Professional		$30.29	$33.03	$42.01
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.16 / $57.38 / $94.93	Facility		$52.16	$57.38	$94.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.87 / $48.51 / $64.15	Professional		$45.87	$48.51	$64.15
CareSource Facility/Professional Facility Modifier Low / Median / High Price $37.52 / $111.62 / $111.62	Facility		$37.52	$111.62	$111.62
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.45 / $140.57 / $218.33	Facility		$34.45	$140.57	$218.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $75.47 / $98.73	Professional		$21.28	$75.47	$98.73
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $14.28 / $43.69 / $59.98	Facility		$14.28	$43.69	$59.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $29.86 / $52.16 / $62.59	Professional		$29.86	$52.16	$62.59
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.38 / $54.52 / $245.00	Facility		$25.38	$54.52	$245.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $20.78 / $26.02 / $56.80	Professional		$20.78	$26.02	$56.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $22.11 / $55.00 / $85.00	Professional		$22.11	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $14.28 / $45.44 / $59.98	Facility		$14.28	$45.44	$59.98
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $29.86 / $52.16 / $62.59	Professional		$29.86	$52.16	$62.59
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.16 / $80.27 / $132.49	Professional		$52.16	$80.27	$132.49
Quartz Facility/Professional Facility Modifier Low / Median / High Price $34.45 / $101.88 / $245.00	Facility		$34.45	$101.88	$245.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.28 / $34.45 / $229.23	Professional		$21.28	$34.45	$229.23
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.16 / $52.16 / $52.16	Professional		$52.16	$52.16	$52.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $52.16 / $52.16 / $52.16	Professional		$52.16	$52.16	$52.16
United Facility/Professional Professional Modifier Low / Median / High Price $17.35 / $26.02 / $44.73	Professional		$17.35	$26.02	$44.73