Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.07 / $71.48 / $84.20	Facility		$35.07	$71.48	$84.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $35.07 / $179.42	Professional		$34.04	$35.07	$179.42
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.56 / $62.99 / $75.93	Facility		$42.56	$62.99	$75.93
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $34.04 / $43.24	Professional		$34.04	$34.04	$43.24
CareSource Facility/Professional Facility Modifier Low / Median / High Price $46.62 / $46.62 / $54.48	Facility		$46.62	$46.62	$54.48
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.04 / $50.99 / $139.06	Facility		$34.04	$50.99	$139.06
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.28 / $75.55 / $85.85	Professional		$40.28	$75.55	$85.85
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $34.04 / $36.65 / $74.84	Facility		$34.04	$36.65	$74.84
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $54.99 / $68.09 / $68.09	Professional		$54.99	$68.09	$68.09
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.65 / $36.65 / $80.56	Facility		$36.65	$36.65	$80.56
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.65 / $36.65 / $68.09	Professional		$36.65	$36.65	$68.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.54 / $65.00 / $85.00	Professional		$39.54	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $34.04 / $36.65 / $74.84	Facility		$34.04	$36.65	$74.84
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $54.99 / $68.09 / $68.09	Professional		$54.99	$68.09	$68.09
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $53.00 / $144.07	Professional		$34.04	$53.00	$144.07
Quartz Facility/Professional Facility Modifier Low / Median / High Price $34.04 / $34.04 / $342.40	Facility		$34.04	$34.04	$342.40
Quartz Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $34.04 / $34.04	Professional		$34.04	$34.04	$34.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.81 / $47.81 / $101.83	Professional		$47.81	$47.81	$101.83
United Facility/Professional Facility Modifier Low / Median / High Price $34.03 / $34.03 / $34.03	Facility		$34.03	$34.03	$34.03
United Facility/Professional Professional Modifier Low / Median / High Price $34.04 / $34.04 / $51.08	Professional		$34.04	$34.04	$51.08