Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.53 / $33.53 / $33.53	Facility		$33.53	$33.53	$33.53
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.53 / $38.40 / $69.81	Professional		$33.53	$38.40	$69.81
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $53.86 / $59.25 / $98.03	Facility		$53.86	$59.25	$98.03
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $50.09 / $53.86 / $66.23	Professional		$50.09	$53.86	$66.23
CareSource Facility/Professional Facility Modifier Low / Median / High Price $72.70 / $115.26 / $115.26	Facility		$72.70	$115.26	$115.26
Cigna Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $209.19 / $257.52	Facility		$57.67	$209.19	$257.52
Cigna Facility/Professional Professional Modifier Low / Median / High Price $42.10 / $89.20 / $101.36	Professional		$42.10	$89.20	$101.36
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.09 / $50.63 / $64.63	Facility		$29.09	$50.63	$64.63
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $27.95 / $57.86 / $64.63	Professional		$27.95	$57.86	$64.63
Medica Facility/Professional Facility Modifier Low / Median / High Price $33.53 / $63.39 / $275.93	Facility		$33.53	$63.39	$275.93
Medica Facility/Professional Professional Modifier Low / Median / High Price $41.66 / $52.56 / $86.68	Professional		$41.66	$52.56	$86.68
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $63.38 / $85.00	Professional		$50.00	$63.38	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.09 / $53.86 / $64.63	Facility		$29.09	$53.86	$64.63
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $27.95 / $57.86 / $64.63	Professional		$27.95	$57.86	$64.63
Quartz Facility/Professional Professional Modifier Low / Median / High Price $53.86 / $65.47 / $123.39	Professional		$53.86	$65.47	$123.39
Quartz Facility/Professional Facility Modifier Low / Median / High Price $57.67 / $104.60 / $275.93	Facility		$57.67	$104.60	$275.93
Quartz Facility/Professional Professional Modifier Low / Median / High Price $42.10 / $57.67 / $420.15	Professional		$42.10	$57.67	$420.15
Security Health Facility/Professional Professional Modifier Low / Median / High Price $82.26 / $82.26 / $82.26	Professional		$82.26	$82.26	$82.26
Security Health Facility/Professional Professional Modifier Low / Median / High Price $80.70 / $82.26 / $94.94	Professional		$80.70	$82.26	$94.94
United Facility/Professional Professional Modifier Low / Median / High Price $37.54 / $50.42 / $86.68	Professional		$37.54	$50.42	$86.68