Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.72 / $77.26 / $91.01	Facility		$40.72	$77.26	$91.01
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.64 / $39.54 / $68.06	Professional		$33.64	$39.54	$68.06
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $49.43 / $49.43 / $49.43	Facility		$49.43	$49.43	$49.43
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $39.54 / $50.21	Professional		$39.54	$39.54	$50.21
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.13 / $54.13 / $63.26	Facility		$54.13	$54.13	$63.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.54 / $88.37 / $126.32	Facility		$39.54	$88.37	$126.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.68 / $70.06 / $79.61	Professional		$33.68	$70.06	$79.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $39.54 / $39.61 / $86.97	Facility		$39.54	$39.61	$86.97
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $30.46 / $79.08 / $79.08	Professional		$30.46	$79.08	$79.08
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.61 / $39.61 / $86.97	Facility		$39.61	$39.61	$86.97
Medica Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $39.61 / $79.08	Professional		$39.61	$39.61	$79.08
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.09 / $65.00 / $85.00	Professional		$32.09	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $39.54 / $39.61 / $86.97	Facility		$39.54	$39.61	$86.97
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $30.46 / $79.08 / $79.08	Professional		$30.46	$79.08	$79.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $45.49 / $101.07	Professional		$39.54	$45.49	$101.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $39.54 / $39.54 / $360.55	Facility		$39.54	$39.54	$360.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $39.54 / $39.54	Professional		$39.54	$39.54	$39.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $39.61 / $39.61 / $39.61	Professional		$39.61	$39.61	$39.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.51 / $55.51 / $88.98	Professional		$55.51	$55.51	$88.98
United Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $39.54 / $59.31	Professional		$39.54	$39.54	$59.31