Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $54.79 / $54.79 / $54.79	Facility		$54.79	$54.79	$54.79
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.43 / $49.31 / $64.63	Professional		$34.43	$49.31	$64.63
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $82.70 / $150.51 / $150.51	Facility		$82.70	$150.51	$150.51
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $76.89 / $76.91 / $111.61	Professional		$76.89	$76.91	$111.61
CareSource Facility/Professional Facility Modifier Low / Median / High Price $5.97 / $44.93 / $176.94	Facility		$5.97	$44.93	$176.94
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.06 / $54.06 / $220.77	Facility		$54.06	$54.06	$220.77
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.06 / $96.00 / $120.00	Professional		$54.06	$96.00	$120.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $51.00 / $66.64 / $98.62	Facility		$51.00	$66.64	$98.62
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $55.33 / $99.96	Professional		$55.33	$55.33	$99.96
Medica Facility/Professional Facility Modifier Low / Median / High Price $51.00 / $99.96 / $387.88	Facility		$51.00	$99.96	$387.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $48.74 / $101.76	Professional		$34.72	$48.74	$101.76
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $58.40 / $86.70	Professional		$50.00	$58.40	$86.70
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $51.00 / $66.64 / $98.62	Facility		$51.00	$66.64	$98.62
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $55.33 / $55.33 / $99.96	Professional		$55.33	$55.33	$99.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.92 / $19.72 / $25.61	Professional		$10.92	$19.72	$25.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $54.06 / $160.54 / $387.88	Facility		$54.06	$160.54	$387.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.06 / $54.06 / $70.95	Professional		$54.06	$54.06	$70.95
Security Health Facility/Professional Professional Modifier Low / Median / High Price $82.99 / $82.99 / $82.99	Professional		$82.99	$82.99	$82.99
Security Health Facility/Professional Professional Modifier Low / Median / High Price $82.99 / $82.99 / $82.99	Professional		$82.99	$82.99	$82.99
United Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $44.93 / $82.99	Professional		$32.11	$44.93	$82.99