Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $47.59 / $47.59 / $47.59	Facility		$47.59	$47.59	$47.59
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.38 / $47.59 / $86.18	Professional		$45.38	$47.59	$86.18
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $94.34 / $103.77 / $171.70	Facility		$94.34	$103.77	$171.70
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $84.90 / $87.74 / $116.03	Professional		$84.90	$87.74	$116.03
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.87 / $201.89 / $201.89	Facility		$67.87	$201.89	$201.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $52.95 / $195.12 / $393.28	Facility		$52.95	$195.12	$393.28
Cigna Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $136.88 / $178.55	Professional		$38.65	$136.88	$178.55
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $23.08 / $71.39 / $108.49	Facility		$23.08	$71.39	$108.49
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $54.01 / $75.06 / $113.21	Professional		$54.01	$75.06	$113.21
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.96 / $94.34 / $377.30	Facility		$39.96	$94.34	$377.30
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.43 / $47.06 / $102.73	Professional		$35.43	$47.06	$102.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.96 / $55.00 / $85.00	Professional		$44.96	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $23.08 / $71.39 / $108.49	Facility		$23.08	$71.39	$108.49
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $54.01 / $75.06 / $113.21	Professional		$54.01	$75.06	$113.21
Quartz Facility/Professional Professional Modifier Low / Median / High Price $94.34 / $141.51 / $214.79	Professional		$94.34	$141.51	$214.79
Quartz Facility/Professional Facility Modifier Low / Median / High Price $52.95 / $184.26 / $377.30	Facility		$52.95	$184.26	$377.30
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.65 / $52.95 / $472.97	Professional		$38.65	$52.95	$472.97
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.34 / $94.34 / $94.34	Professional		$94.34	$94.34	$94.34
Security Health Facility/Professional Professional Modifier Low / Median / High Price $94.34 / $94.34 / $94.34	Professional		$94.34	$94.34	$94.34
United Facility/Professional Professional Modifier Low / Median / High Price $32.47 / $47.06 / $94.34	Professional		$32.47	$47.06	$94.34