Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $30.15 / $30.15 / $30.15	Facility		$30.15	$30.15	$30.15
Aetna Facility/Professional Professional Modifier Low / Median / High Price $28.54 / $30.15 / $54.20	Professional		$28.54	$30.15	$54.20
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.76 / $65.73 / $108.76	Facility		$59.76	$65.73	$108.76
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $53.78 / $55.58 / $73.50	Professional		$53.78	$55.58	$73.50
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.99 / $127.89 / $127.89	Facility		$42.99	$127.89	$127.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.99 / $132.24 / $249.12	Facility		$43.99	$132.24	$249.12
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $86.72 / $113.10	Professional		$32.11	$86.72	$113.10
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $17.19 / $45.23 / $68.72	Facility		$17.19	$45.23	$68.72
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $58.29 / $71.70	Professional		$34.22	$58.29	$71.70
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.75 / $59.76 / $278.23	Facility		$29.75	$59.76	$278.23
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.10 / $31.30 / $65.06	Professional		$26.10	$31.30	$65.06
Molina Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $58.40 / $85.00	Professional		$33.07	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $17.19 / $45.23 / $68.72	Facility		$17.19	$45.23	$68.72
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $34.22 / $58.29 / $71.70	Professional		$34.22	$58.29	$71.70
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.76 / $91.96 / $159.59	Professional		$59.76	$91.96	$159.59
Quartz Facility/Professional Facility Modifier Low / Median / High Price $43.99 / $116.72 / $278.23	Facility		$43.99	$116.72	$278.23
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.11 / $43.99 / $300.94	Professional		$32.11	$43.99	$300.94
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.76 / $59.76 / $59.76	Professional		$59.76	$59.76	$59.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $47.72 / $59.76 / $59.76	Professional		$47.72	$59.76	$59.76
United Facility/Professional Professional Modifier Low / Median / High Price $22.19 / $30.77 / $52.98	Professional		$22.19	$30.77	$52.98