Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $52.00 / $52.00 / $52.00	Facility		$52.00	$52.00	$52.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.60 / $52.00 / $52.00	Professional		$36.60	$52.00	$52.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.00 / $61.00 / $111.02	Facility		$61.00	$61.00	$111.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $61.00 / $75.03	Professional		$56.73	$61.00	$75.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $61.00 / $130.54 / $130.54	Facility		$61.00	$130.54	$130.54
Cigna Facility/Professional Facility Modifier Low / Median / High Price $163.10 / $190.60 / $253.32	Facility		$163.10	$190.60	$253.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $21.25 / $88.59 / $114.76	Professional		$21.25	$88.59	$114.76
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $52.00 / $52.00 / $77.48	Facility		$52.00	$52.00	$77.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $61.00 / $61.00	Professional		$61.00	$61.00	$61.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.49 / $52.00 / $79.56	Facility		$38.49	$52.00	$79.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.53 / $37.92 / $95.94	Professional		$35.53	$37.92	$95.94
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $70.00 / $150.46	Professional		$50.00	$70.00	$150.46
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $52.00 / $52.00 / $77.48	Facility		$52.00	$52.00	$77.48
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $61.00 / $61.00	Professional		$61.00	$61.00	$61.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $91.50 / $181.67	Professional		$61.00	$91.50	$181.67
Quartz Facility/Professional Facility Modifier Low / Median / High Price $118.44 / $123.83 / $285.48	Facility		$118.44	$123.83	$285.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $21.25 / $266.49 / $303.77	Professional		$21.25	$266.49	$303.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $61.00 / $61.00 / $61.00	Professional		$61.00	$61.00	$61.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $43.14 / $61.00 / $61.00	Professional		$43.14	$61.00	$61.00
United Facility/Professional Facility Modifier Low / Median / High Price $48.80 / $48.80 / $48.80	Facility		$48.80	$48.80	$48.80
United Facility/Professional Professional Modifier Low / Median / High Price $31.98 / $35.53 / $68.09	Professional		$31.98	$35.53	$68.09