Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $50.99 / $50.99 / $50.99	Facility		$50.99	$50.99	$50.99
Aetna Facility/Professional Professional Modifier Low / Median / High Price $48.34 / $50.99 / $200.71	Professional		$48.34	$50.99	$200.71
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.56 / $69.56 / $114.79	Facility		$69.56	$69.56	$114.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $64.70 / $64.70 / $76.52	Professional		$64.70	$64.70	$76.52
CareSource Facility/Professional Facility Modifier Low / Median / High Price $62.61 / $148.88 / $148.88	Facility		$62.61	$148.88	$148.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $186.53 / $217.98 / $334.38	Facility		$186.53	$217.98	$334.38
Cigna Facility/Professional Professional Modifier Low / Median / High Price $56.91 / $100.78 / $131.66	Professional		$56.91	$100.78	$131.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $48.34 / $69.56 / $73.05	Facility		$48.34	$69.56	$73.05
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $24.85 / $24.85	Professional		$24.85	$24.85	$24.85
Medica Facility/Professional Facility Modifier Low / Median / High Price $50.99 / $69.56 / $325.58	Facility		$50.99	$69.56	$325.58
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.70 / $78.66 / $211.24	Professional		$34.70	$78.66	$211.24
Molina Facility/Professional Professional Modifier Low / Median / High Price $65.00 / $65.00 / $90.00	Professional		$65.00	$65.00	$90.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $48.34 / $69.56 / $73.05	Facility		$48.34	$69.56	$73.05
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $24.85 / $24.85 / $24.85	Professional		$24.85	$24.85	$24.85
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.56 / $104.95 / $207.77	Professional		$69.56	$104.95	$207.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $135.88 / $141.22 / $325.58	Facility		$135.88	$141.22	$325.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $56.91 / $56.91 / $56.91	Professional		$56.91	$56.91	$56.91
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.56 / $69.56 / $69.56	Professional		$69.56	$69.56	$69.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.56 / $69.56 / $69.56	Professional		$69.56	$69.56	$69.56
United Facility/Professional Professional Modifier Low / Median / High Price $27.18 / $69.56 / $211.24	Professional		$27.18	$69.56	$211.24