Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.91 / $30.91 / $30.91	Facility		$30.91	$30.91	$30.91
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.27 / $32.89 / $42.58	Professional		$29.27	$32.89	$42.58
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $61.29 / $67.42 / $111.55	Facility		$61.29	$67.42	$111.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $57.00 / $57.00 / $75.38	Professional		$57.00	$57.00	$75.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $44.09 / $131.16 / $131.16	Facility		$44.09	$131.16	$131.16
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.22 / $135.25 / $256.12	Facility		$34.22	$135.25	$256.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $88.59 / $115.99	Professional		$24.98	$88.59	$115.99
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $17.64 / $46.06 / $70.48	Facility		$17.64	$46.06	$70.48
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $59.84 / $73.55	Professional		$35.10	$59.84	$73.55
Medica Facility/Professional Facility Modifier Low / Median / High Price $30.54 / $61.29 / $285.48	Facility		$30.54	$61.29	$285.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.77 / $32.10 / $66.73	Professional		$26.77	$32.10	$66.73
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.51 / $55.00 / $85.00	Professional		$24.51	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $17.64 / $46.37 / $70.48	Facility		$17.64	$46.37	$70.48
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $35.10 / $59.84 / $73.55	Professional		$35.10	$59.84	$73.55
Quartz Facility/Professional Professional Modifier Low / Median / High Price $61.29 / $94.32 / $163.60	Professional		$61.29	$94.32	$163.60
Quartz Facility/Professional Facility Modifier Low / Median / High Price $34.22 / $119.70 / $285.48	Facility		$34.22	$119.70	$285.48
Quartz Facility/Professional Professional Modifier Low / Median / High Price $24.98 / $34.22 / $308.61	Professional		$24.98	$34.22	$308.61
Security Health Facility/Professional Professional Modifier Low / Median / High Price $61.29 / $61.29 / $61.29	Professional		$61.29	$61.29	$61.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $48.94 / $61.29 / $61.29	Professional		$48.94	$61.29	$61.29
United Facility/Professional Professional Modifier Low / Median / High Price $22.77 / $30.58 / $54.33	Professional		$22.77	$30.58	$54.33