Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $41.07 / $41.07 / $41.07	Facility		$41.07	$41.07	$41.07
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.46 / $41.07 / $59.75	Professional		$31.46	$41.07	$59.75
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $81.41 / $89.55 / $148.16	Facility		$81.41	$89.55	$148.16
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $75.70 / $75.70 / $100.13	Professional		$75.70	$75.70	$100.13
CareSource Facility/Professional Facility Modifier Low / Median / High Price $58.57 / $174.22 / $174.22	Facility		$58.57	$174.22	$174.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $55.83 / $167.92 / $340.09	Facility		$55.83	$167.92	$340.09
Cigna Facility/Professional Professional Modifier Low / Median / High Price $40.76 / $135.59 / $154.08	Professional		$40.76	$135.59	$154.08
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.33 / $61.61 / $93.62	Facility		$21.33	$61.61	$93.62
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $46.62 / $81.41 / $97.69	Professional		$46.62	$81.41	$97.69
Medica Facility/Professional Facility Modifier Low / Median / High Price $36.94 / $81.41 / $362.42	Facility		$36.94	$81.41	$362.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $32.44 / $40.61 / $88.65	Professional		$32.44	$40.61	$88.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.25 / $58.40 / $85.00	Professional		$44.25	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.33 / $61.61 / $93.62	Facility		$21.33	$61.61	$93.62
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $46.62 / $81.41 / $97.69	Professional		$46.62	$81.41	$97.69
Quartz Facility/Professional Professional Modifier Low / Median / High Price $81.41 / $125.29 / $198.73	Professional		$81.41	$125.29	$198.73
Quartz Facility/Professional Facility Modifier Low / Median / High Price $55.83 / $159.00 / $362.42	Facility		$55.83	$159.00	$362.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $40.76 / $55.83 / $492.89	Professional		$40.76	$55.83	$492.89
Security Health Facility/Professional Professional Modifier Low / Median / High Price $81.41 / $81.41 / $81.41	Professional		$81.41	$81.41	$81.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $81.41 / $81.41 / $81.41	Professional		$81.41	$81.41	$81.41
United Facility/Professional Professional Modifier Low / Median / High Price $27.08 / $40.61 / $81.41	Professional		$27.08	$40.61	$81.41