Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $66.63 / $66.63 / $66.63	Facility		$66.63	$66.63	$66.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $40.71 / $60.45 / $76.40	Professional		$40.71	$60.45	$76.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.70 / $172.35 / $172.35	Facility		$94.70	$172.35	$172.35
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $88.06 / $88.07 / $127.83	Professional		$88.06	$88.07	$127.83
CareSource Facility/Professional Facility Modifier Low / Median / High Price $8.53 / $64.06 / $202.64	Facility		$8.53	$64.06	$202.64
Cigna Facility/Professional Facility Modifier Low / Median / High Price $64.23 / $64.23 / $255.92	Facility		$64.23	$64.23	$255.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.60 / $111.00 / $138.75	Professional		$54.60	$111.00	$138.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $63.45 / $94.96 / $136.51	Facility		$63.45	$94.96	$136.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $142.44 / $142.44 / $142.44	Professional		$142.44	$142.44	$142.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $63.45 / $136.51 / $433.65	Facility		$63.45	$136.51	$433.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $46.76 / $57.37 / $122.81	Professional		$46.76	$57.37	$122.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.19 / $55.00 / $65.00	Professional		$36.19	$55.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $63.45 / $99.95 / $136.51	Facility		$63.45	$99.95	$136.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $142.44 / $142.44 / $142.44	Professional		$142.44	$142.44	$142.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $12.50 / $21.30 / $27.65	Professional		$12.50	$21.30	$27.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $64.23 / $183.86 / $433.65	Facility		$64.23	$183.86	$433.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $64.23 / $64.23 / $79.36	Professional		$64.23	$64.23	$79.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.43 / $109.43 / $109.43	Professional		$109.43	$109.43	$109.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.43 / $109.43 / $109.43	Professional		$109.43	$109.43	$109.43
United Facility/Professional Professional Modifier Low / Median / High Price $38.97 / $57.37 / $119.60	Professional		$38.97	$57.37	$119.60