Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.34 / $34.34 / $34.34	Facility		$34.34	$34.34	$34.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.21 / $34.34 / $45.04	Professional		$25.21	$34.34	$45.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.15 / $59.15 / $97.60	Facility		$59.15	$59.15	$97.60
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.01 / $59.15 / $72.75	Professional		$55.01	$59.15	$72.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.15 / $126.58 / $126.58	Facility		$59.15	$126.58	$126.58
Cigna Facility/Professional Facility Modifier Low / Median / High Price $158.60 / $185.33 / $246.32	Facility		$158.60	$185.33	$246.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.73 / $85.78 / $111.94	Professional		$31.73	$85.78	$111.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.22 / $48.08 / $59.15	Facility		$33.22	$48.08	$59.15
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $59.15 / $59.15	Professional		$59.15	$59.15	$59.15
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.11 / $45.04 / $60.60	Facility		$33.11	$45.04	$60.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.19 / $33.57 / $76.11	Professional		$28.19	$33.57	$76.11
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.43 / $65.00 / $85.00	Professional		$37.43	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $33.22 / $48.74 / $59.15	Facility		$33.22	$48.74	$59.15
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $59.15 / $59.15	Professional		$59.15	$59.15	$59.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $88.73 / $158.00	Professional		$59.15	$88.73	$158.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $115.52 / $120.07 / $275.37	Facility		$115.52	$120.07	$275.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.73 / $259.92 / $298.10	Professional		$31.73	$259.92	$298.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $59.15 / $59.15	Professional		$59.15	$59.15	$59.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $59.15 / $59.15	Professional		$59.15	$59.15	$59.15
United Facility/Professional Professional Modifier Low / Median / High Price $20.64 / $29.51 / $49.18	Professional		$20.64	$29.51	$49.18