Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $76.95 / $76.95 / $76.95	Facility		$76.95	$76.95	$76.95
Aetna Facility/Professional Professional Modifier Low / Median / High Price $47.13 / $71.33 / $88.47	Professional		$47.13	$71.33	$88.47
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $109.40 / $199.11 / $199.11	Facility		$109.40	$199.11	$199.11
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $101.72 / $101.74 / $147.66	Professional		$101.72	$101.74	$147.66
CareSource Facility/Professional Facility Modifier Low / Median / High Price $7.70 / $77.12 / $293.20	Facility		$7.70	$77.12	$293.20
Cigna Facility/Professional Facility Modifier Low / Median / High Price $73.04 / $73.04 / $304.58	Facility		$73.04	$73.04	$304.58
Cigna Facility/Professional Professional Modifier Low / Median / High Price $73.04 / $132.38 / $165.47	Professional		$73.04	$132.38	$165.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $37.51 / $109.61 / $157.56	Facility		$37.51	$109.61	$157.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $66.68 / $66.68 / $164.41	Professional		$66.68	$66.68	$164.41
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.51 / $164.41 / $523.65	Facility		$37.51	$164.41	$523.65
Medica Facility/Professional Professional Modifier Low / Median / High Price $49.24 / $65.18 / $135.97	Professional		$49.24	$65.18	$135.97
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.35 / $58.40 / $73.92	Professional		$44.35	$58.40	$73.92
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $37.51 / $109.61 / $157.56	Facility		$37.51	$109.61	$157.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $66.68 / $66.68 / $164.41	Professional		$66.68	$66.68	$164.41
Quartz Facility/Professional Professional Modifier Low / Median / High Price $14.44 / $24.45 / $31.75	Professional		$14.44	$24.45	$31.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $73.04 / $212.40 / $523.65	Facility		$73.04	$212.40	$523.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.04 / $73.04 / $95.86	Professional		$73.04	$73.04	$95.86
Security Health Facility/Professional Professional Modifier Low / Median / High Price $129.87 / $129.87 / $129.87	Professional		$129.87	$129.87	$129.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $129.87 / $129.87 / $129.87	Professional		$129.87	$129.87	$129.87
United Facility/Professional Facility Modifier Low / Median / High Price $5.16 / $43.65 / $65.42	Facility		$5.16	$43.65	$65.42
United Facility/Professional Professional Modifier Low / Median / High Price $43.15 / $64.50 / $129.87	Professional		$43.15	$64.50	$129.87