Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $36.77 / $36.77 / $36.77	Facility		$36.77	$36.77	$36.77
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.11 / $36.77 / $62.91	Professional		$33.11	$36.77	$62.91
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $72.88 / $80.17 / $132.63	Facility		$72.88	$80.17	$132.63
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.78 / $67.78 / $89.64	Professional		$67.78	$67.78	$89.64
CareSource Facility/Professional Facility Modifier Low / Median / High Price $52.43 / $155.96 / $155.96	Facility		$52.43	$155.96	$155.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.58 / $151.03 / $303.70	Facility		$43.58	$151.03	$303.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.81 / $105.47 / $137.93	Professional		$31.81	$105.47	$137.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.47 / $55.16 / $83.81	Facility		$22.47	$55.16	$83.81
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $41.73 / $72.88 / $87.46	Professional		$41.73	$72.88	$87.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.77 / $72.88 / $368.08	Facility		$36.77	$72.88	$368.08
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.18 / $41.73 / $82.28	Professional		$32.18	$41.73	$82.28
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $55.00 / $85.00	Professional		$33.07	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $22.47 / $55.16 / $83.81	Facility		$22.47	$55.16	$83.81
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $41.73 / $72.88 / $87.46	Professional		$41.73	$72.88	$87.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $72.88 / $112.17 / $208.77	Professional		$72.88	$112.17	$208.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $43.58 / $142.34 / $368.08	Facility		$43.58	$142.34	$368.08
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.81 / $43.58 / $446.11	Professional		$31.81	$43.58	$446.11
Security Health Facility/Professional Professional Modifier Low / Median / High Price $72.88 / $72.88 / $72.88	Professional		$72.88	$72.88	$72.88
Security Health Facility/Professional Professional Modifier Low / Median / High Price $58.19 / $72.88 / $72.88	Professional		$58.19	$72.88	$72.88
United Facility/Professional Facility Modifier Low / Median / High Price $44.00 / $44.00 / $44.00	Facility		$44.00	$44.00	$44.00
United Facility/Professional Professional Modifier Low / Median / High Price $27.25 / $40.22 / $69.69	Professional		$27.25	$40.22	$69.69