Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.20 / $38.20 / $38.20	Facility		$38.20	$38.20	$38.20
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.20 / $45.47 / $52.62	Professional		$38.20	$45.47	$52.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $75.73 / $83.30 / $137.83	Facility		$75.73	$83.30	$137.83
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.43 / $70.43 / $93.14	Professional		$70.43	$70.43	$93.14
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.48 / $162.06 / $162.06	Facility		$54.48	$162.06	$162.06
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $156.65 / $316.30	Facility		$48.98	$156.65	$316.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.76 / $109.69 / $143.31	Professional		$35.76	$109.69	$143.31
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.39 / $57.30 / $87.09	Facility		$24.39	$57.30	$87.09
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $43.36 / $75.73 / $100.97	Professional		$43.36	$75.73	$100.97
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.20 / $75.17 / $399.39	Facility		$38.20	$75.17	$399.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.31 / $44.08 / $85.50	Professional		$34.31	$44.08	$85.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.60 / $55.00 / $85.00	Professional		$28.60	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.39 / $57.30 / $87.09	Facility		$24.39	$57.30	$87.09
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $43.36 / $75.73 / $100.97	Professional		$43.36	$75.73	$100.97
Quartz Facility/Professional Professional Modifier Low / Median / High Price $75.73 / $116.55 / $226.84	Professional		$75.73	$116.55	$226.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $48.98 / $147.90 / $399.39	Facility		$48.98	$147.90	$399.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.76 / $48.98 / $662.00	Professional		$35.76	$48.98	$662.00
Security Health Facility/Professional Professional Modifier Low / Median / High Price $75.73 / $75.73 / $75.73	Professional		$75.73	$75.73	$75.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.47 / $75.73 / $75.73	Professional		$60.47	$75.73	$75.73
United Facility/Professional Professional Modifier Low / Median / High Price $30.17 / $37.84 / $72.42	Professional		$30.17	$37.84	$72.42