Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.11 / $46.11 / $46.11	Facility		$46.11	$46.11	$46.11
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.53 / $39.52 / $52.70	Professional		$30.53	$39.52	$52.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.79 / $72.37 / $119.74	Facility		$65.79	$72.37	$119.74
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $46.47 / $61.18 / $80.92	Professional		$46.47	$61.18	$80.92
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.26 / $140.79 / $140.79	Facility		$44.26	$140.79	$140.79
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.23 / $203.78 / $278.51	Facility		$44.23	$203.78	$278.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.60 / $97.50 / $123.78	Professional		$37.60	$97.50	$123.78
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $37.42 / $64.83 / $78.95	Facility		$37.42	$64.83	$78.95
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.96 / $61.96 / $78.95	Professional		$61.96	$61.96	$78.95
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.67 / $65.79 / $310.80	Facility		$39.67	$65.79	$310.80
Medica Facility/Professional Professional Modifier Low / Median / High Price $33.61 / $46.47 / $138.53	Professional		$33.61	$46.47	$138.53
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $70.00	Professional		$50.00	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $38.49 / $65.79 / $78.95	Facility		$38.49	$65.79	$78.95
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $61.96 / $61.96 / $78.95	Professional		$61.96	$61.96	$78.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.79 / $118.88 / $184.21	Professional		$65.79	$118.88	$184.21
Quartz Facility/Professional Facility Modifier Low / Median / High Price $44.23 / $160.00 / $310.80	Facility		$44.23	$160.00	$310.80
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.60 / $48.89 / $630.37	Professional		$37.60	$48.89	$630.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.87 / $74.87 / $74.87	Professional		$74.87	$74.87	$74.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $74.87 / $74.87 / $74.87	Professional		$74.87	$74.87	$74.87
United Facility/Professional Professional Modifier Low / Median / High Price $23.41 / $44.92 / $88.85	Professional		$23.41	$44.92	$88.85