Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $31.80 / $31.80 / $31.80	Facility		$31.80	$31.80	$31.80
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.80 / $35.89 / $71.77	Professional		$31.80	$35.89	$71.77
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $63.04 / $69.34 / $114.73	Facility		$63.04	$69.34	$114.73
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $56.73 / $58.63 / $77.53	Professional		$56.73	$58.63	$77.53
CareSource Facility/Professional Facility Modifier Low / Median / High Price $45.35 / $134.91 / $134.91	Facility		$45.35	$134.91	$134.91
Cigna Facility/Professional Facility Modifier Low / Median / High Price $40.77 / $130.38 / $263.12	Facility		$40.77	$130.38	$263.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $29.76 / $104.98 / $119.30	Professional		$29.76	$104.98	$119.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $20.07 / $47.70 / $72.50	Facility		$20.07	$47.70	$72.50
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $36.09 / $63.04 / $75.65	Professional		$36.09	$63.04	$75.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $31.80 / $63.04 / $327.13	Facility		$31.80	$63.04	$327.13
Medica Facility/Professional Professional Modifier Low / Median / High Price $28.39 / $36.29 / $71.15	Professional		$28.39	$36.29	$71.15
Molina Facility/Professional Professional Modifier Low / Median / High Price $18.16 / $55.00 / $85.00	Professional		$18.16	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $20.07 / $47.70 / $72.50	Facility		$20.07	$47.70	$72.50
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $36.09 / $63.04 / $75.65	Professional		$36.09	$63.04	$75.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $63.04 / $97.02 / $186.69	Professional		$63.04	$97.02	$186.69
Quartz Facility/Professional Facility Modifier Low / Median / High Price $40.77 / $123.12 / $327.13	Facility		$40.77	$123.12	$327.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $29.76 / $40.77 / $398.90	Professional		$29.76	$40.77	$398.90
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.04 / $63.04 / $63.04	Professional		$63.04	$63.04	$63.04
Security Health Facility/Professional Professional Modifier Low / Median / High Price $63.04 / $63.04 / $63.04	Professional		$63.04	$63.04	$63.04
United Facility/Professional Professional Modifier Low / Median / High Price $24.35 / $34.56 / $58.27	Professional		$24.35	$34.56	$58.27