Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.63 / $58.63 / $58.63	Facility		$58.63	$58.63	$58.63
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.31 / $54.61 / $65.58	Professional		$35.31	$54.61	$65.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $84.80 / $154.34 / $154.34	Facility		$84.80	$154.34	$154.34
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $78.86 / $81.29 / $114.48	Professional		$78.86	$81.29	$114.48
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.10 / $61.61 / $197.52	Facility		$6.10	$61.61	$197.52
Cigna Facility/Professional Facility Modifier Low / Median / High Price $35.54 / $35.54 / $237.90	Facility		$35.54	$35.54	$237.90
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $103.13 / $128.91	Professional		$35.54	$103.13	$128.91
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $73.84 / $106.15	Facility		$27.30	$73.84	$106.15
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $56.08 / $56.08 / $110.76	Professional		$56.08	$56.08	$110.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $110.76 / $405.24	Facility		$27.30	$110.76	$405.24
Medica Facility/Professional Professional Modifier Low / Median / High Price $37.25 / $46.95 / $103.47	Professional		$37.25	$46.95	$103.47
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.76 / $55.00 / $65.00	Professional		$36.76	$55.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $27.30 / $79.78 / $106.15	Facility		$27.30	$79.78	$106.15
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $56.08 / $56.08 / $110.76	Professional		$56.08	$56.08	$110.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.19 / $18.93 / $24.58	Professional		$11.19	$18.93	$24.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $59.70 / $169.72 / $405.24	Facility		$59.70	$169.72	$405.24
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.54 / $35.54 / $74.12	Professional		$35.54	$35.54	$74.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.32 / $92.32 / $92.32	Professional		$92.32	$92.32	$92.32
Security Health Facility/Professional Professional Modifier Low / Median / High Price $92.32 / $92.32 / $92.32	Professional		$92.32	$92.32	$92.32
United Facility/Professional Professional Modifier Low / Median / High Price $30.53 / $48.88 / $103.47	Professional		$30.53	$48.88	$103.47