Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.15 / $66.53 / $78.38	Facility		$35.15	$66.53	$78.38
Aetna Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $44.71 / $102.00	Professional		$43.41	$44.71	$102.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $54.26 / $54.26 / $54.26	Facility		$54.26	$54.26	$54.26
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $43.41 / $55.13	Professional		$43.41	$43.41	$55.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $59.43 / $59.43 / $69.45	Facility		$59.43	$59.43	$69.45
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.41 / $118.84 / $169.87	Facility		$43.41	$118.84	$169.87
Cigna Facility/Professional Professional Modifier Low / Median / High Price $14.88 / $16.91 / $63.75	Professional		$14.88	$16.91	$63.75
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.15 / $34.11 / $95.52	Facility		$29.15	$34.11	$95.52
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $8.27 / $86.82 / $86.82	Professional		$8.27	$86.82	$86.82
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.15 / $34.11 / $74.84	Facility		$29.15	$34.11	$74.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.11 / $34.11 / $71.65	Professional		$34.11	$34.11	$71.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.07 / $65.00 / $85.00	Professional		$50.07	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.15 / $34.11 / $95.52	Facility		$29.15	$34.11	$95.52
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $8.27 / $86.82 / $86.82	Professional		$8.27	$86.82	$86.82
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $58.29 / $155.00	Professional		$43.41	$58.29	$155.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $221.08 / $221.08 / $221.08	Facility		$221.08	$221.08	$221.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $43.41 / $43.41	Professional		$43.41	$43.41	$43.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $34.11 / $34.11 / $34.11	Professional		$34.11	$34.11	$34.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $39.59 / $60.95 / $64.08	Professional		$39.59	$60.95	$64.08
United Facility/Professional Professional Modifier Low / Median / High Price $43.41 / $43.41 / $60.00	Professional		$43.41	$43.41	$60.00