Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.46 / $38.46 / $38.46	Facility		$38.46	$38.46	$38.46
Aetna Facility/Professional Professional Modifier Low / Median / High Price $38.45 / $38.46 / $73.03	Professional		$38.45	$38.46	$73.03
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.25 / $83.88 / $138.78	Facility		$76.25	$83.88	$138.78
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.62 / $70.91 / $93.78	Professional		$68.62	$70.91	$93.78
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.86 / $163.18 / $163.18	Facility		$54.86	$163.18	$163.18
Cigna Facility/Professional Facility Modifier Low / Median / High Price $54.11 / $157.60 / $317.70	Facility		$54.11	$157.60	$317.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $39.50 / $110.63 / $144.30	Professional		$39.50	$110.63	$144.30
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $24.56 / $57.69 / $87.69	Facility		$24.56	$57.69	$87.69
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $43.66 / $76.25 / $101.66	Professional		$43.66	$76.25	$101.66
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.46 / $80.06 / $395.32	Facility		$38.46	$80.06	$395.32
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.53 / $44.38 / $86.07	Professional		$34.53	$44.38	$86.07
Molina Facility/Professional Professional Modifier Low / Median / High Price $8.64 / $55.00 / $85.00	Professional		$8.64	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $24.56 / $57.69 / $87.69	Facility		$24.56	$57.69	$87.69
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $43.66 / $76.25 / $101.66	Professional		$43.66	$76.25	$101.66
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.25 / $117.35 / $227.84	Professional		$76.25	$117.35	$227.84
Quartz Facility/Professional Facility Modifier Low / Median / High Price $54.11 / $148.91 / $395.32	Facility		$54.11	$148.91	$395.32
Quartz Facility/Professional Professional Modifier Low / Median / High Price $39.50 / $54.11 / $503.22	Professional		$39.50	$54.11	$503.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $76.25 / $76.25 / $76.25	Professional		$76.25	$76.25	$76.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $60.89 / $76.25 / $76.25	Professional		$60.89	$76.25	$76.25
United Facility/Professional Facility Modifier Low / Median / High Price $48.00 / $48.00 / $48.00	Facility		$48.00	$48.00	$48.00
United Facility/Professional Professional Modifier Low / Median / High Price $30.38 / $43.97 / $83.02	Professional		$30.38	$43.97	$83.02