Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $63.02 / $63.02 / $63.02	Facility		$63.02	$63.02	$63.02
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $55.89 / $72.54	Professional		$38.65	$55.89	$72.54
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $90.50 / $164.71 / $164.71	Facility		$90.50	$164.71	$164.71
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.14 / $90.47 / $122.13	Professional		$84.14	$90.47	$122.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.90 / $59.13 / $193.61	Facility		$7.90	$59.13	$193.61
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.54 / $57.54 / $236.99	Facility		$57.54	$57.54	$236.99
Cigna Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $102.75 / $128.44	Professional		$57.54	$102.75	$128.44
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $34.79 / $87.66 / $126.01	Facility		$34.79	$87.66	$126.01
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $72.78 / $72.78 / $131.47	Professional		$72.78	$72.78	$131.47
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.79 / $131.47 / $413.01	Facility		$34.79	$131.47	$413.01
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.65 / $60.59 / $111.64	Professional		$43.65	$60.59	$111.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $45.03 / $58.40 / $75.05	Professional		$45.03	$58.40	$75.05
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $34.79 / $94.53 / $126.01	Facility		$34.79	$94.53	$126.01
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $72.78 / $72.78 / $131.47	Professional		$72.78	$72.78	$131.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.95 / $18.93 / $24.58	Professional		$11.95	$18.93	$24.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $65.00 / $175.68 / $413.01	Facility		$65.00	$175.68	$413.01
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.54 / $57.54 / $75.52	Professional		$57.54	$57.54	$75.52
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.26 / $102.26 / $102.26	Professional		$102.26	$102.26	$102.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $102.26 / $102.26 / $102.26	Professional		$102.26	$102.26	$102.26
United Facility/Professional Professional Modifier Low / Median / High Price $37.38 / $59.10 / $111.64	Professional		$37.38	$59.10	$111.64