Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.64 / $36.64 / $36.64	Facility		$36.64	$36.64	$36.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.44 / $39.95 / $50.83	Professional		$35.44	$39.95	$50.83
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.10 / $69.41 / $114.84	Facility		$63.10	$69.41	$114.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.72 / $58.68 / $77.61	Professional		$57.72	$58.68	$77.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.39 / $135.03 / $135.03	Facility		$45.39	$135.03	$135.03
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.90 / $188.00 / $263.12	Facility		$37.90	$188.00	$263.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $92.87 / $119.43	Professional		$32.22	$92.87	$119.43
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $17.28 / $52.85 / $72.56	Facility		$17.28	$52.85	$72.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $36.13 / $63.10 / $75.72	Professional		$36.13	$63.10	$75.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.71 / $65.95 / $296.43	Facility		$30.71	$65.95	$296.43
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.76 / $31.83 / $73.16	Professional		$26.76	$31.83	$73.16
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 $17.28 / $54.96 / $72.56	Facility		$17.28	$54.96	$72.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $36.13 / $63.10 / $75.72	Professional		$36.13	$63.10	$75.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $97.12 / $160.59	Professional		$63.10	$97.12	$160.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $37.90 / $123.24 / $296.43	Facility		$37.90	$123.24	$296.43
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.22 / $37.90 / $314.24	Professional		$32.22	$37.90	$314.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.10 / $63.10 / $63.10	Professional		$63.10	$63.10	$63.10
United Facility/Professional Professional Modifier Low / Median / High Price $22.68 / $35.36 / $60.34	Professional		$22.68	$35.36	$60.34