Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $56.60 / $56.60 / $56.60	Facility		$56.60	$56.60	$56.60
Aetna Facility/Professional Professional Modifier Low / Median / High Price $34.59 / $49.15 / $64.93	Professional		$34.59	$49.15	$64.93
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $83.40 / $151.79 / $151.79	Facility		$83.40	$151.79	$151.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $77.56 / $77.59 / $112.59	Professional		$77.56	$77.59	$112.59
CareSource Facility/Professional Facility Modifier Low / Median / High Price $6.61 / $49.56 / $178.56	Facility		$6.61	$49.56	$178.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $46.80 / $46.80 / $211.76	Facility		$46.80	$46.80	$211.76
Cigna Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $92.25 / $115.31	Professional		$46.80	$92.25	$115.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.16 / $73.50 / $105.66	Facility		$25.16	$73.50	$105.66
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $52.61 / $52.61 / $110.26	Professional		$52.61	$52.61	$110.26
Medica Facility/Professional Facility Modifier Low / Median / High Price $25.16 / $105.66 / $380.20	Facility		$25.16	$105.66	$380.20
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.02 / $45.03 / $101.09	Professional		$36.02	$45.03	$101.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $26.23 / $50.00 / $65.00	Professional		$26.23	$50.00	$65.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.16 / $73.50 / $105.66	Facility		$25.16	$73.50	$105.66
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $52.61 / $52.61 / $110.26	Professional		$52.61	$52.61	$110.26
Quartz Facility/Professional Professional Modifier Low / Median / High Price $11.01 / $18.93 / $24.58	Professional		$11.01	$18.93	$24.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $46.80 / $162.02 / $380.20	Facility		$46.80	$162.02	$380.20
Quartz Facility/Professional Professional Modifier Low / Median / High Price $46.80 / $46.80 / $63.10	Professional		$46.80	$46.80	$63.10
Security Health Facility/Professional Professional Modifier Low / Median / High Price $90.24 / $90.24 / $90.24	Professional		$90.24	$90.24	$90.24
Security Health Facility/Professional Professional Modifier Low / Median / High Price $90.24 / $90.24 / $90.24	Professional		$90.24	$90.24	$90.24
United Facility/Professional Professional Modifier Low / Median / High Price $33.02 / $48.82 / $90.24	Professional		$33.02	$48.82	$90.24