Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.13 / $41.13 / $41.13	Facility		$41.13	$41.13	$41.13
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $41.13 / $61.70	Professional		$32.47	$41.13	$61.70
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.53 / $89.68 / $148.38	Facility		$81.53	$89.68	$148.38
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.51 / $75.81 / $100.28	Professional		$70.51	$75.81	$100.28
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.65 / $174.47 / $174.47	Facility		$58.65	$174.47	$174.47
Cigna Facility/Professional Facility Modifier Low / Median / High Price $36.72 / $168.85 / $340.09	Facility		$36.72	$168.85	$340.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $26.81 / $118.13 / $154.30	Professional		$26.81	$118.13	$154.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.72 / $61.70 / $93.76	Facility		$21.72	$61.70	$93.76
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $46.69 / $77.04 / $97.84	Professional		$46.69	$77.04	$97.84
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.60 / $81.53 / $353.81	Facility		$37.60	$81.53	$353.81
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.49 / $40.67 / $88.77	Professional		$32.49	$40.67	$88.77
Molina Facility/Professional Professional Modifier Low / Median / High Price $47.59 / $58.40 / $85.00	Professional		$47.59	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.72 / $61.70 / $93.76	Facility		$21.72	$61.70	$93.76
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $46.69 / $77.04 / $97.84	Professional		$46.69	$77.04	$97.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.53 / $125.47 / $201.74	Professional		$81.53	$125.47	$201.74
Quartz Facility/Professional Facility Modifier Low / Median / High Price $36.72 / $159.24 / $353.81	Facility		$36.72	$159.24	$353.81
Quartz Facility/Professional Professional Modifier Low / Median / High Price $26.81 / $36.72 / $389.12	Professional		$26.81	$36.72	$389.12
Security Health Facility/Professional Professional Modifier Low / Median / High Price $81.53 / $81.53 / $81.53	Professional		$81.53	$81.53	$81.53
Security Health Facility/Professional Professional Modifier Low / Median / High Price $65.11 / $81.53 / $81.53	Professional		$65.11	$81.53	$81.53
United Facility/Professional Professional Modifier Low / Median / High Price $28.04 / $40.67 / $81.53	Professional		$28.04	$40.67	$81.53