Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.78 / $42.78 / $42.78	Facility		$42.78	$42.78	$42.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.48 / $36.67 / $48.89	Professional		$28.48	$36.67	$48.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.06 / $64.97 / $107.49	Facility		$59.06	$64.97	$107.49
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $38.72 / $54.93 / $67.31	Professional		$38.72	$54.93	$67.31
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.74 / $126.39 / $126.39	Facility		$39.74	$126.39	$126.39
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.36 / $165.81 / $257.52	Facility		$40.36	$165.81	$257.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $34.31 / $90.96 / $111.13	Professional		$34.31	$90.96	$111.13
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $34.85 / $59.06 / $70.87	Facility		$34.85	$59.06	$70.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.96 / $61.96 / $70.87	Professional		$61.96	$61.96	$70.87
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.85 / $59.06 / $283.33	Facility		$34.85	$59.06	$283.33
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.31 / $46.47 / $92.99	Professional		$25.31	$46.47	$92.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.77 / $58.40 / $70.00	Professional		$47.77	$58.40	$70.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $34.85 / $59.06 / $70.87	Facility		$34.85	$59.06	$70.87
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $61.96 / $61.96 / $70.87	Professional		$61.96	$61.96	$70.87
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.06 / $110.43 / $171.12	Professional		$59.06	$110.43	$171.12
Quartz Facility/Professional Facility Modifier Low / Median / High Price $40.36 / $160.00 / $283.33	Facility		$40.36	$160.00	$283.33
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.31 / $258.02 / $317.97	Professional		$34.31	$258.02	$317.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $71.53 / $71.53 / $71.53	Professional		$71.53	$71.53	$71.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $71.53 / $71.53 / $71.53	Professional		$71.53	$71.53	$71.53
United Facility/Professional Professional Modifier Low / Median / High Price $21.39 / $37.54 / $77.45	Professional		$21.39	$37.54	$77.45