Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.54 / $30.54 / $30.54	Facility		$30.54	$30.54	$30.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.43 / $30.54 / $48.31	Professional		$25.43	$30.54	$48.31
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $60.54 / $66.59 / $110.18	Facility		$60.54	$66.59	$110.18
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $54.48 / $56.30 / $74.45	Professional		$54.48	$56.30	$74.45
CareSource Facility/Professional Facility Modifier Low / Median / High Price $43.56 / $129.56 / $129.56	Facility		$43.56	$129.56	$129.56
Cigna Facility/Professional Facility Modifier Low / Median / High Price $39.15 / $124.76 / $253.32	Facility		$39.15	$124.76	$253.32
Cigna Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $87.66 / $114.58	Professional		$28.59	$87.66	$114.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $17.25 / $45.81 / $69.62	Facility		$17.25	$45.81	$69.62
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $34.65 / $60.54 / $72.65	Professional		$34.65	$60.54	$72.65
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.86 / $60.54 / $295.50	Facility		$29.86	$60.54	$295.50
Medica Facility/Professional Professional Modifier Low / Median / High Price $24.71 / $31.79 / $66.81	Professional		$24.71	$31.79	$66.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $36.64 / $55.00 / $85.00	Professional		$36.64	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $17.25 / $45.81 / $69.62	Facility		$17.25	$45.81	$69.62
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $34.65 / $60.54 / $72.65	Professional		$34.65	$60.54	$72.65
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.54 / $93.16 / $160.59	Professional		$60.54	$93.16	$160.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $39.15 / $118.24 / $295.50	Facility		$39.15	$118.24	$295.50
Quartz Facility/Professional Professional Modifier Low / Median / High Price $28.59 / $39.15 / $534.87	Professional		$28.59	$39.15	$534.87
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.54 / $60.54 / $60.54	Professional		$60.54	$60.54	$60.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $48.35 / $60.54 / $60.54	Professional		$48.35	$60.54	$60.54
United Facility/Professional Facility Modifier Low / Median / High Price $51.23 / $51.23 / $51.23	Facility		$51.23	$51.23	$51.23
United Facility/Professional Professional Modifier Low / Median / High Price $20.92 / $30.89 / $60.54	Professional		$20.92	$30.89	$60.54