Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $81.45 / $81.45 / $81.45	Facility		$81.45	$81.45	$81.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $49.67 / $70.26 / $93.22	Professional		$49.67	$70.26	$93.22
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $117.60 / $214.03 / $214.03	Facility		$117.60	$214.03	$214.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $90.95 / $109.37 / $147.00	Professional		$90.95	$109.37	$147.00
CareSource Facility/Professional Facility Modifier Low / Median / High Price $10.46 / $75.33 / $251.66	Facility		$10.46	$75.33	$251.66
Cigna Facility/Professional Facility Modifier Low / Median / High Price $74.67 / $74.67 / $295.57	Facility		$74.67	$74.67	$295.57
Cigna Facility/Professional Professional Modifier Low / Median / High Price $74.67 / $128.25 / $160.31	Professional		$74.67	$128.25	$160.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $38.22 / $111.70 / $160.57	Facility		$38.22	$111.70	$160.57
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $79.94 / $79.94 / $167.56	Professional		$79.94	$79.94	$167.56
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.22 / $160.57 / $535.95	Facility		$38.22	$160.57	$535.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.74 / $68.43 / $148.86	Professional		$54.74	$68.43	$148.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $39.85 / $55.00 / $66.43	Professional		$39.85	$55.00	$66.43
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $38.22 / $111.70 / $160.57	Facility		$38.22	$111.70	$160.57
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $79.94 / $79.94 / $167.56	Professional		$79.94	$79.94	$167.56
Quartz Facility/Professional Professional Modifier Low / Median / High Price $15.52 / $25.24 / $32.77	Professional		$15.52	$25.24	$32.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $74.67 / $228.34 / $535.95	Facility		$74.67	$228.34	$535.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $74.67 / $74.67 / $88.56	Professional		$74.67	$74.67	$88.56
Security Health Facility/Professional Professional Modifier Low / Median / High Price $131.62 / $131.62 / $131.62	Professional		$131.62	$131.62	$131.62
Security Health Facility/Professional Professional Modifier Low / Median / High Price $131.62 / $131.62 / $131.62	Professional		$131.62	$131.62	$131.62
United Facility/Professional Professional Modifier Low / Median / High Price $41.90 / $68.43 / $141.69	Professional		$41.90	$68.43	$141.69