Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.42 / $83.70 / $96.14	Facility		$43.42	$83.70	$96.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $42.15 / $43.42 / $57.89	Professional		$42.15	$43.42	$57.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $52.70 / $78.00 / $94.02	Facility		$52.70	$78.00	$94.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $42.16 / $42.16 / $56.91	Professional		$42.16	$42.16	$56.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.85 / $58.59 / $77.27	Facility		$41.85	$58.59	$77.27
CareSource Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $42.16 / $97.75	Professional		$41.85	$42.16	$97.75
Cigna Facility/Professional Facility Modifier Low / Median / High Price $42.16 / $61.52 / $112.54	Facility		$42.16	$61.52	$112.54
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.16 / $52.36 / $68.00	Professional		$42.16	$52.36	$68.00
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $36.25 / $42.16 / $72.41	Facility		$36.25	$42.16	$72.41
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $62.78 / $84.32 / $84.32	Professional		$62.78	$84.32	$84.32
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.25 / $41.85 / $60.35	Facility		$36.25	$41.85	$60.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.85 / $46.59 / $4,110.43	Professional		$41.85	$46.59	$4,110.43
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $36.25 / $42.16 / $72.41	Facility		$36.25	$42.16	$72.41
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $62.78 / $84.32 / $84.32	Professional		$62.78	$84.32	$84.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.16 / $53.37 / $127.00	Professional		$42.16	$53.37	$127.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $42.16 / $85.00 / $205.55	Facility		$42.16	$85.00	$205.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.16 / $75.37 / $4,110.43	Professional		$42.16	$75.37	$4,110.43
Security Health Facility/Professional Professional Modifier Low / Median / High Price $39.02 / $59.19 / $59.19	Professional		$39.02	$59.19	$59.19
United Facility/Professional Facility Modifier Low / Median / High Price $41.11 / $41.11 / $88.39	Facility		$41.11	$41.11	$88.39
United Facility/Professional Professional Modifier Low / Median / High Price $42.16 / $43.43 / $50.17	Professional		$42.16	$43.43	$50.17