Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.50 / $40.50 / $40.50	Facility		$40.50	$40.50	$40.50
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.50 / $44.17 / $56.19	Professional		$40.50	$44.17	$56.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.75 / $76.73 / $126.95	Facility		$69.75	$76.73	$126.95
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.81 / $64.87 / $85.79	Professional		$61.81	$64.87	$85.79
CareSource Facility/Professional Facility Modifier Low / Median / High Price $50.18 / $149.27 / $149.27	Facility		$50.18	$149.27	$149.27
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.70 / $187.43 / $291.11	Facility		$37.70	$187.43	$291.11
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $101.25 / $132.01	Professional		$28.46	$101.25	$132.01
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.09 / $58.42 / $80.20	Facility		$19.09	$58.42	$80.20
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $69.75 / $83.70	Professional		$39.93	$69.75	$83.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.94 / $72.90 / $327.64	Facility		$33.94	$72.90	$327.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.58 / $35.18 / $80.84	Professional		$29.58	$35.18	$80.84
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.43 / $55.41 / $85.00	Professional		$45.43	$55.41	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.09 / $60.75 / $80.20	Facility		$19.09	$60.75	$80.20
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $39.93 / $69.75 / $83.70	Professional		$39.93	$69.75	$83.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.75 / $107.36 / $177.65	Professional		$69.75	$107.36	$177.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $37.70 / $136.24 / $327.64	Facility		$37.70	$136.24	$327.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.46 / $37.70 / $306.54	Professional		$28.46	$37.70	$306.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.75 / $69.75 / $69.75	Professional		$69.75	$69.75	$69.75
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.75 / $69.75 / $69.75	Professional		$69.75	$69.75	$69.75
United Facility/Professional Professional Modifier Low / Median / High Price $24.65 / $34.79 / $69.75	Professional		$24.65	$34.79	$69.75