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 / $94.58 / $127.83	Professional		$88.06	$94.58	$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 $60.46 / $60.46 / $255.92	Facility		$60.46	$60.46	$255.92
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.46 / $111.00 / $138.75	Professional		$60.46	$111.00	$138.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $94.96 / $136.51	Facility		$58.00	$94.96	$136.51
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $78.86 / $78.86 / $142.44	Professional		$78.86	$78.86	$142.44
Medica Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $141.19 / $433.65	Facility		$58.00	$141.19	$433.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $47.29 / $65.66 / $122.81	Professional		$47.29	$65.66	$122.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.09 / $58.40 / $71.83	Professional		$43.09	$58.40	$71.83
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $99.95 / $136.51	Facility		$58.00	$99.95	$136.51
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $78.86 / $78.86 / $142.44	Professional		$78.86	$78.86	$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 $65.00 / $183.86 / $433.65	Facility		$65.00	$183.86	$433.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.46 / $60.46 / $80.95	Professional		$60.46	$60.46	$80.95
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 $39.56 / $64.04 / $116.90	Professional		$39.56	$64.04	$116.90