Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Facility		$70.00	$70.00	$70.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $70.00	Professional		$70.00	$70.00	$70.00
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $27.82 / $54.25 / $168.00	Professional		$27.82	$54.25	$168.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.57 / $56.26 / $66.20	Facility		$44.57	$56.26	$66.20
CareSource Facility/Professional Professional Modifier Low / Median / High Price $39.29 / $49.74 / $62.40	Professional		$39.29	$49.74	$62.40
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $105.00	Facility		$70.00	$70.00	$105.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $105.00	Facility		$70.00	$70.00	$105.00
Medica Facility/Professional Professional Modifier Low / Median / High Price $259.38 / $259.38 / $259.38	Professional		$259.38	$259.38	$259.38
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $60.00 / $106.94	Professional		$50.00	$60.00	$106.94
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $70.00 / $70.00 / $105.00	Facility		$70.00	$70.00	$105.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $62.75 / $115.16 / $165.80	Professional		$62.75	$115.16	$165.80
Quartz Facility/Professional Facility Modifier Low / Median / High Price $254.31 / $254.31 / $254.31	Facility		$254.31	$254.31	$254.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $206.06 / $259.38 / $259.38	Professional		$206.06	$259.38	$259.38
Security Health Facility/Professional Professional Modifier Low / Median / High Price $132.93 / $132.93 / $140.32	Professional		$132.93	$132.93	$140.32