Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.40 / $31.40 / $31.40	Facility		$31.40	$31.40	$31.40
Aetna Facility/Professional Professional Modifier Low / Median / High Price $16.80 / $31.40 / $43.56	Professional		$16.80	$31.40	$43.56
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.08 / $59.49 / $98.43	Facility		$54.08	$59.49	$98.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $50.29 / $66.51	Professional		$46.76	$50.29	$66.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $64.90 / $115.73	Facility		$38.90	$64.90	$115.73
CareSource Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $56.78 / $75.70	Professional		$54.08	$56.78	$75.70
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.21 / $161.00 / $225.33	Facility		$36.21	$161.00	$225.33
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.43 / $79.53 / $102.35	Professional		$26.43	$79.53	$102.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $15.68 / $45.29 / $62.19	Facility		$15.68	$45.29	$62.19
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $54.08 / $64.90	Professional		$30.97	$54.08	$64.90
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.14 / $56.52 / $253.09	Facility		$27.14	$56.52	$253.09
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.95 / $36.14 / $63.76	Professional		$24.95	$36.14	$63.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.26 / $57.55 / $85.00	Professional		$28.26	$57.55	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $15.68 / $47.10 / $62.19	Facility		$15.68	$47.10	$62.19
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $30.97 / $54.08 / $64.90	Professional		$30.97	$54.08	$64.90
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $83.21 / $145.54	Professional		$54.08	$83.21	$145.54
Quartz Facility/Professional Facility Modifier Low / Median / High Price $36.21 / $105.62 / $253.09	Facility		$36.21	$105.62	$253.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.43 / $36.21 / $269.32	Professional		$26.43	$36.21	$269.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $54.08 / $54.08	Professional		$54.08	$54.08	$54.08
Security Health Facility/Professional Professional Modifier Low / Median / High Price $54.08 / $54.08 / $54.08	Professional		$54.08	$54.08	$54.08
United Facility/Professional Professional Modifier Low / Median / High Price $21.55 / $34.54 / $51.70	Professional		$21.55	$34.54	$51.70