Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.64 / $39.64 / $39.64	Facility		$39.64	$39.64	$39.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.79 / $39.64 / $55.00	Professional		$35.79	$39.64	$55.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $68.28 / $75.11 / $124.27	Facility		$68.28	$75.11	$124.27
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.45 / $63.50 / $83.98	Professional		$61.45	$63.50	$83.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.13 / $146.12 / $146.12	Facility		$49.13	$146.12	$146.12
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.02 / $183.83 / $285.51	Facility		$41.02	$183.83	$285.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.86 / $113.72 / $129.22	Professional		$34.86	$113.72	$129.22
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.69 / $55.50 / $78.52	Facility		$18.69	$55.50	$78.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $68.28 / $81.94	Professional		$35.36	$68.28	$81.94
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.22 / $68.28 / $305.60	Facility		$33.22	$68.28	$305.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.00 / $34.07 / $74.34	Professional		$27.00	$34.07	$74.34
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 $18.69 / $59.46 / $78.52	Facility		$18.69	$59.46	$78.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $35.36 / $68.28 / $81.94	Professional		$35.36	$68.28	$81.94
Quartz Facility/Professional Professional Modifier Low / Median / High Price $68.28 / $105.07 / $173.64	Professional		$68.28	$105.07	$173.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $41.02 / $133.36 / $305.60	Facility		$41.02	$133.36	$305.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.86 / $46.87 / $366.48	Professional		$34.86	$46.87	$366.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $68.28 / $68.28 / $68.28	Professional		$68.28	$68.28	$68.28
Security Health Facility/Professional Professional Modifier Low / Median / High Price $68.28 / $68.28 / $68.28	Professional		$68.28	$68.28	$68.28
United Facility/Professional Professional Modifier Low / Median / High Price $22.71 / $34.07 / $68.28	Professional		$22.71	$34.07	$68.28