Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.07 / $33.07 / $33.07	Facility		$33.07	$33.07	$33.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $35.19 / $43.38	Professional		$33.07	$35.19	$43.38
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $56.97 / $62.67 / $103.69	Facility		$56.97	$62.67	$103.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.90 / $52.98 / $70.06	Professional		$49.90	$52.98	$70.06
CareSource Facility/Professional Facility Modifier Low / Median / High Price $40.98 / $121.92 / $121.92	Facility		$40.98	$121.92	$121.92
Cigna Facility/Professional Facility Modifier Low / Median / High Price $136.00 / $179.02 / $274.61	Facility		$136.00	$179.02	$274.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $23.24 / $94.88 / $107.81	Professional		$23.24	$94.88	$107.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $15.59 / $47.71 / $65.52	Facility		$15.59	$47.71	$65.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $56.97 / $68.36	Professional		$32.61	$56.97	$68.36
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.72 / $59.53 / $257.45	Facility		$27.72	$59.53	$257.45
Medica Facility/Professional Professional Modifier Low / Median / High Price $22.99 / $29.10 / $66.03	Professional		$22.99	$29.10	$66.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.20 / $55.00 / $85.00	Professional		$32.20	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $15.59 / $49.61 / $65.52	Facility		$15.59	$49.61	$65.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $32.61 / $56.97 / $68.36	Professional		$32.61	$56.97	$68.36
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $87.67 / $144.53	Professional		$56.97	$87.67	$144.53
Quartz Facility/Professional Facility Modifier Low / Median / High Price $111.26 / $111.26 / $257.45	Facility		$111.26	$111.26	$257.45
Quartz Facility/Professional Professional Modifier Low / Median / High Price $23.24 / $86.56 / $367.11	Professional		$23.24	$86.56	$367.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $56.97 / $56.97	Professional		$56.97	$56.97	$56.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $56.97 / $56.97 / $56.97	Professional		$56.97	$56.97	$56.97
United Facility/Professional Professional Modifier Low / Median / High Price $20.47 / $28.42 / $56.97	Professional		$20.47	$28.42	$56.97