Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.68 / $39.68 / $39.68	Facility		$39.68	$39.68	$39.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.60 / $35.14 / $42.34	Professional		$23.60	$35.14	$42.34
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $58.00 / $105.56 / $105.56	Facility		$58.00	$105.56	$105.56
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.89 / $53.94 / $78.23	Professional		$53.89	$53.94	$78.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.08 / $40.85 / $141.41	Facility		$4.08	$40.85	$141.41
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.06 / $36.06 / $177.15	Facility		$36.06	$36.06	$177.15
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $67.50 / $84.38	Professional		$36.06	$67.50	$84.38
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $37.13 / $52.86 / $75.98	Facility		$37.13	$52.86	$75.98
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $79.30 / $79.30 / $79.30	Professional		$79.30	$79.30	$79.30
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.13 / $75.98 / $258.29	Facility		$37.13	$75.98	$258.29
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.45 / $34.70 / $67.64	Professional		$25.45	$34.70	$67.64
Molina Facility/Professional Professional Modifier Low / Median / High Price $15.51 / $50.00 / $65.00	Professional		$15.51	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $37.13 / $59.52 / $75.98	Facility		$37.13	$59.52	$75.98
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $79.30 / $79.30 / $79.30	Professional		$79.30	$79.30	$79.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $7.66 / $12.62 / $16.39	Professional		$7.66	$12.62	$16.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $36.06 / $112.52 / $258.29	Facility		$36.06	$112.52	$258.29
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.06 / $36.06 / $47.33	Professional		$36.06	$36.06	$47.33
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.78 / $62.78 / $62.78	Professional		$62.78	$62.78	$62.78
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.78 / $62.78 / $62.78	Professional		$62.78	$62.78	$62.78
United Facility/Professional Professional Modifier Low / Median / High Price $20.82 / $34.70 / $67.64	Professional		$20.82	$34.70	$67.64