Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $58.78 / $58.78 / $58.78	Facility		$58.78	$58.78	$58.78
Aetna Facility/Professional Professional Modifier Low / Median / High Price $36.44 / $52.96 / $68.40	Professional		$36.44	$52.96	$68.40
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $87.90 / $159.97 / $159.97	Facility		$87.90	$159.97	$159.97
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $81.73 / $81.75 / $118.65	Professional		$81.73	$81.75	$118.65
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.19 / $61.96 / $196.37	Facility		$6.19	$61.96	$196.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.33 / $44.33 / $235.19	Facility		$44.33	$44.33	$235.19
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.68 / $102.00 / $127.50	Professional		$37.68	$102.00	$127.50
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.13 / $73.41 / $105.80	Facility		$25.13	$73.41	$105.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $52.55 / $52.55 / $110.11	Professional		$52.55	$52.55	$110.11
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.13 / $110.11 / $407.44	Facility		$25.13	$110.11	$407.44
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.97 / $49.99 / $107.90	Professional		$35.97	$49.99	$107.90
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.49 / $54.15 / $65.00	Professional		$32.49	$54.15	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.13 / $73.41 / $105.80	Facility		$25.13	$73.41	$105.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $52.55 / $52.55 / $110.11	Professional		$52.55	$52.55	$110.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.60 / $19.72 / $25.61	Professional		$11.60	$19.72	$25.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $44.33 / $170.66 / $407.44	Facility		$44.33	$170.66	$407.44
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.68 / $44.33 / $67.81	Professional		$37.68	$44.33	$67.81
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.77 / $91.77 / $91.77	Professional		$91.77	$91.77	$91.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $91.77 / $91.77 / $91.77	Professional		$91.77	$91.77	$91.77
United Facility/Professional Professional Modifier Low / Median / High Price $32.97 / $44.98 / $105.47	Professional		$32.97	$44.98	$105.47