Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.15 / $38.15 / $38.15	Facility		$38.15	$38.15	$38.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.72 / $41.62 / $52.94	Professional		$28.72	$41.62	$52.94
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.73 / $72.30 / $119.63	Facility		$65.73	$72.30	$119.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $58.23 / $61.13 / $80.84	Professional		$58.23	$61.13	$80.84
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.29 / $140.66 / $140.66	Facility		$47.29	$140.66	$140.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.47 / $196.00 / $274.31	Facility		$39.47	$196.00	$274.31
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.56 / $96.68 / $124.40	Professional		$33.56	$96.68	$124.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.00 / $55.05 / $75.59	Facility		$18.00	$55.05	$75.59
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $37.64 / $65.73 / $78.88	Professional		$37.64	$65.73	$78.88
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.99 / $68.69 / $308.79	Facility		$31.99	$68.69	$308.79
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.87 / $34.99 / $79.19	Professional		$27.87	$34.99	$79.19
Molina Facility/Professional Professional Modifier Low / Median / High Price $49.82 / $60.76 / $85.00	Professional		$49.82	$60.76	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.00 / $57.24 / $75.59	Facility		$18.00	$57.24	$75.59
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $37.64 / $65.73 / $78.88	Professional		$37.64	$65.73	$78.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.73 / $101.15 / $167.62	Professional		$65.73	$101.15	$167.62
Quartz Facility/Professional Facility Modifier Low / Median / High Price $48.77 / $128.38 / $308.79	Facility		$48.77	$128.38	$308.79
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.56 / $40.65 / $327.33	Professional		$33.56	$40.65	$327.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $65.73 / $65.73 / $65.73	Professional		$65.73	$65.73	$65.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $65.73 / $65.73 / $65.73	Professional		$65.73	$65.73	$65.73
United Facility/Professional Professional Modifier Low / Median / High Price $21.86 / $32.79 / $65.73	Professional		$21.86	$32.79	$65.73