Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $46.45 / $46.45 / $46.45	Facility		$46.45	$46.45	$46.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.25 / $41.40 / $54.89	Professional		$29.25	$41.40	$54.89
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.60 / $115.75 / $115.75	Facility		$63.60	$115.75	$115.75
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $59.15 / $62.45 / $79.50	Professional		$59.15	$62.45	$79.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.46 / $44.85 / $144.24	Facility		$6.46	$44.85	$144.24
Cigna Facility/Professional Facility Modifier Low / Median / High Price $41.54 / $41.54 / $167.61	Facility		$41.54	$41.54	$167.61
Cigna Facility/Professional Professional Modifier Low / Median / High Price $41.54 / $72.75 / $90.94	Professional		$41.54	$72.75	$90.94
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $70.73 / $103.43	Facility		$40.00	$70.73	$103.43
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $59.74 / $59.74 / $107.93	Professional		$59.74	$59.74	$107.93
Medica Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $89.94 / $297.88	Facility		$40.00	$89.94	$297.88
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.54 / $48.50 / $83.40	Professional		$34.54	$48.50	$83.40
Molina Facility/Professional Professional Modifier Low / Median / High Price $37.48 / $55.00 / $65.00	Professional		$37.48	$55.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $40.00 / $70.73 / $103.43	Facility		$40.00	$70.73	$103.43
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $59.74 / $59.74 / $107.93	Professional		$59.74	$59.74	$107.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.40 / $13.41 / $17.41	Professional		$8.40	$13.41	$17.41
Quartz Facility/Professional Facility Modifier Low / Median / High Price $41.54 / $123.50 / $297.88	Facility		$41.54	$123.50	$297.88
Quartz Facility/Professional Professional Modifier Low / Median / High Price $41.54 / $41.54 / $55.62	Professional		$41.54	$41.54	$55.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $79.19 / $79.19 / $79.19	Professional		$79.19	$79.19	$79.19
Security Health Facility/Professional Professional Modifier Low / Median / High Price $79.19 / $79.19 / $79.19	Professional		$79.19	$79.19	$79.19
United Facility/Professional Professional Modifier Low / Median / High Price $32.83 / $47.64 / $83.29	Professional		$32.83	$47.64	$83.29