Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $40.72 / $40.72 / $40.72	Facility		$40.72	$40.72	$40.72
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.59 / $36.65 / $48.04	Professional		$25.59	$36.65	$48.04
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.00 / $111.02 / $111.02	Facility		$61.00	$111.02	$111.02
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.71 / $56.73 / $82.32	Professional		$56.71	$56.73	$82.32
CareSource Facility/Professional Facility Modifier Low / Median / High Price $4.59 / $34.17 / $130.50	Facility		$4.59	$34.17	$130.50
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.90 / $39.90 / $163.10	Facility		$39.90	$39.90	$163.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $70.88 / $88.59	Professional		$39.90	$70.88	$88.59
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $20.12 / $50.68 / $73.31	Facility		$20.12	$50.68	$73.31
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $42.09 / $42.09 / $76.02	Professional		$42.09	$42.09	$76.02
Medica Facility/Professional Facility Modifier Low / Median / High Price $20.12 / $76.02 / $286.32	Facility		$20.12	$76.02	$286.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.42 / $36.02 / $76.02	Professional		$26.42	$36.02	$76.02
Molina Facility/Professional Professional Modifier Low / Median / High Price $20.97 / $50.00 / $65.00	Professional		$20.97	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $20.12 / $50.68 / $73.31	Facility		$20.12	$50.68	$73.31
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $42.09 / $42.09 / $76.02	Professional		$42.09	$42.09	$76.02
Quartz Facility/Professional Professional Modifier Low / Median / High Price $8.05 / $14.20 / $18.44	Professional		$8.05	$14.20	$18.44
Quartz Facility/Professional Facility Modifier Low / Median / High Price $39.90 / $118.42 / $286.32	Facility		$39.90	$118.42	$286.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.90 / $39.90 / $47.93	Professional		$39.90	$39.90	$47.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.16 / $62.16 / $62.16	Professional		$62.16	$62.16	$62.16
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.16 / $62.16 / $62.16	Professional		$62.16	$62.16	$62.16
United Facility/Professional Professional Modifier Low / Median / High Price $23.68 / $34.17 / $73.09	Professional		$23.68	$34.17	$73.09