Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $34.89 / $68.95 / $79.19	Facility		$34.89	$68.95	$79.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $34.89 / $2,335.44	Professional		$33.88	$34.89	$2,335.44
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $42.35 / $62.68 / $75.55	Facility		$42.35	$62.68	$75.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $45.73	Professional		$33.88	$33.88	$45.73
CareSource Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $46.38 / $51.72	Facility		$33.88	$46.38	$51.72
CareSource Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $34.47 / $78.55	Professional		$33.88	$34.47	$78.55
Cigna Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $68.47 / $118.78	Facility		$33.88	$68.47	$118.78
Cigna Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $43.15 / $63.96	Professional		$33.88	$43.15	$63.96
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $34.54 / $40.65	Facility		$33.88	$34.54	$40.65
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $51.72 / $67.76 / $67.76	Professional		$51.72	$67.76	$67.76
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.47 / $34.82 / $38.36	Facility		$34.47	$34.82	$38.36
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.47 / $34.47 / $155.61	Professional		$34.47	$34.47	$155.61
Molina Facility/Professional Professional Modifier Low / Median / High Price $35.44 / $65.00 / $85.00	Professional		$35.44	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $34.47 / $40.65	Facility		$33.88	$34.47	$40.65
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $51.72 / $67.76 / $67.76	Professional		$51.72	$67.76	$67.76
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $52.73 / $117.79	Professional		$33.88	$52.73	$117.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $33.88 / $33.88 / $173.60	Facility		$33.88	$33.88	$173.60
Quartz Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $64.84 / $155.61	Professional		$33.88	$64.84	$155.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.57 / $47.57 / $61.10	Professional		$47.57	$47.57	$61.10
United Facility/Professional Professional Modifier Low / Median / High Price $33.88 / $33.88 / $44.04	Professional		$33.88	$33.88	$44.04