Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $53.68 / $53.68 / $53.68	Facility		$53.68	$53.68	$53.68
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.89 / $45.33 / $59.84	Professional		$31.89	$45.33	$59.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.59 / $141.22 / $141.22	Facility		$77.59	$141.22	$141.22
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.17 / $72.18 / $104.76	Professional		$72.17	$72.18	$104.76
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.62 / $49.49 / $166.09	Facility		$6.62	$49.49	$166.09
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.02 / $48.02 / $189.24	Facility		$48.02	$48.02	$189.24
Cigna Facility/Professional Professional Modifier Low / Median / High Price $48.02 / $82.13 / $102.66	Professional		$48.02	$82.13	$102.66
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.14 / $73.38 / $105.49	Facility		$29.14	$73.38	$105.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $60.94 / $60.94 / $110.08	Professional		$60.94	$60.94	$110.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.14 / $110.08 / $344.64	Facility		$29.14	$110.08	$344.64
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.54 / $51.11 / $94.62	Professional		$36.54	$51.11	$94.62
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.01 / $50.00 / $65.00	Professional		$36.01	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.14 / $73.38 / $105.49	Facility		$29.14	$73.38	$105.49
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $60.94 / $60.94 / $110.08	Professional		$60.94	$60.94	$110.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.24 / $15.78 / $20.48	Professional		$10.24	$15.78	$20.48
Quartz Facility/Professional Facility Modifier Low / Median / High Price $48.02 / $150.69 / $344.64	Facility		$48.02	$150.69	$344.64
Quartz Facility/Professional Professional Modifier Low / Median / High Price $48.02 / $48.02 / $56.29	Professional		$48.02	$48.02	$56.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $85.54 / $85.54 / $85.54	Professional		$85.54	$85.54	$85.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $85.54 / $85.54 / $85.54	Professional		$85.54	$85.54	$85.54
United Facility/Professional Professional Modifier Low / Median / High Price $30.60 / $49.49 / $85.54	Professional		$30.60	$49.49	$85.54