Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.46 / $56.46 / $56.46	Facility		$56.46	$56.46	$56.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.47 / $50.81 / $66.59	Professional		$35.47	$50.81	$66.59
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.10 / $151.24 / $151.24	Facility		$83.10	$151.24	$151.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.27 / $77.28 / $112.17	Professional		$77.27	$77.28	$112.17
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.64 / $49.67 / $177.81	Facility		$6.64	$49.67	$177.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.52 / $54.52 / $221.68	Facility		$54.52	$54.52	$221.68
Cigna Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $96.38 / $120.47	Professional		$54.52	$96.38	$120.47
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.25 / $73.68 / $105.92	Facility		$29.25	$73.68	$105.92
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $61.18 / $61.18 / $110.52	Professional		$61.18	$61.18	$110.52
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.25 / $110.52 / $391.25	Facility		$29.25	$110.52	$391.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $38.40 / $51.18 / $107.36	Professional		$38.40	$51.18	$107.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.63 / $54.39 / $65.00	Professional		$32.63	$54.39	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.25 / $73.68 / $105.92	Facility		$29.25	$73.68	$105.92
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $61.18 / $61.18 / $110.52	Professional		$61.18	$61.18	$110.52
Quartz Facility/Professional Professional Modifier Low / Median / High Price $10.97 / $20.51 / $26.63	Professional		$10.97	$20.51	$26.63
Quartz Facility/Professional Facility Modifier Low / Median / High Price $54.52 / $161.34 / $391.25	Facility		$54.52	$161.34	$391.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $54.52 / $54.52 / $65.30	Professional		$54.52	$54.52	$65.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $87.59 / $87.59 / $87.59	Professional		$87.59	$87.59	$87.59
Security Health Facility/Professional Professional Modifier Low / Median / High Price $87.59 / $87.59 / $87.59	Professional		$87.59	$87.59	$87.59
United Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $50.93 / $101.31	Professional		$34.79	$50.93	$101.31