Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $61.25 / $61.25 / $61.25	Facility		$61.25	$61.25	$61.25
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.61 / $56.71 / $69.23	Professional		$38.61	$56.71	$69.23
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $90.20 / $164.16 / $164.16	Facility		$90.20	$164.16	$164.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $83.89 / $83.90 / $121.77	Professional		$83.89	$83.90	$121.77
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.36 / $63.60 / $213.40	Facility		$6.36	$63.60	$213.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.10 / $44.10 / $241.50	Facility		$44.10	$44.10	$241.50
Cigna Facility/Professional Professional Modifier Low / Median / High Price $44.10 / $105.00 / $131.25	Professional		$44.10	$105.00	$131.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.99 / $80.45 / $114.68	Facility		$29.99	$80.45	$114.68
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $53.32 / $53.32 / $119.66	Professional		$53.32	$53.32	$119.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.99 / $119.66 / $402.15	Facility		$29.99	$119.66	$402.15
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.36 / $51.58 / $111.62	Professional		$39.36	$51.58	$111.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $40.39 / $55.20 / $67.31	Professional		$40.39	$55.20	$67.31
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.99 / $80.45 / $114.68	Facility		$29.99	$80.45	$114.68
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $53.32 / $53.32 / $119.66	Professional		$53.32	$53.32	$119.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.91 / $18.93 / $24.58	Professional		$11.91	$18.93	$24.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $44.10 / $175.18 / $402.15	Facility		$44.10	$175.18	$402.15
Quartz Facility/Professional Professional Modifier Low / Median / High Price $44.10 / $44.10 / $68.56	Professional		$44.10	$44.10	$68.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $97.94	Professional		$97.94	$97.94	$97.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $97.94 / $97.94 / $97.94	Professional		$97.94	$97.94	$97.94
United Facility/Professional Professional Modifier Low / Median / High Price $35.42 / $49.58 / $106.25	Professional		$35.42	$49.58	$106.25