Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.27 / $33.27 / $33.27	Facility		$33.27	$33.27	$33.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.49 / $33.27 / $45.82	Professional		$23.49	$33.27	$45.82
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $65.94 / $72.53 / $120.01	Facility		$65.94	$72.53	$120.01
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $61.32 / $61.32 / $81.09	Professional		$61.32	$61.32	$81.09
CareSource Facility/Professional Facility Modifier Low / Median / High Price $47.44 / $141.11 / $141.11	Facility		$47.44	$141.11	$141.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $30.91 / $136.05 / $275.70	Facility		$30.91	$136.05	$275.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $22.56 / $95.63 / $124.81	Professional		$22.56	$95.63	$124.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $15.93 / $49.91 / $75.83	Facility		$15.93	$49.91	$75.83
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $37.76 / $65.94 / $79.13	Professional		$37.76	$65.94	$79.13
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.58 / $65.91 / $263.25	Facility		$27.58	$65.91	$263.25
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.67 / $32.90 / $71.81	Professional		$24.67	$32.90	$71.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.58 / $58.40 / $85.00	Professional		$30.58	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $15.93 / $49.91 / $75.83	Facility		$15.93	$49.91	$75.83
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $37.76 / $65.94 / $79.13	Professional		$37.76	$65.94	$79.13
Quartz Facility/Professional Professional Modifier Low / Median / High Price $65.94 / $98.91 / $148.55	Professional		$65.94	$98.91	$148.55
Quartz Facility/Professional Facility Modifier Low / Median / High Price $30.91 / $128.80 / $263.25	Facility		$30.91	$128.80	$263.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $22.56 / $30.91 / $316.51	Professional		$22.56	$30.91	$316.51
Security Health Facility/Professional Professional Modifier Low / Median / High Price $65.94 / $65.94 / $65.94	Professional		$65.94	$65.94	$65.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $65.94 / $65.94 / $65.94	Professional		$65.94	$65.94	$65.94
United Facility/Professional Professional Modifier Low / Median / High Price $22.41 / $32.90 / $58.47	Professional		$22.41	$32.90	$58.47