Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.42 / $39.42 / $39.42	Facility		$39.42	$39.42	$39.42
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.31 / $39.42 / $70.86	Professional		$37.31	$39.42	$70.86
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.14 / $85.95 / $142.21	Facility		$78.14	$85.95	$142.21
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $70.31 / $72.67 / $96.11	Professional		$70.31	$72.67	$96.11
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.22 / $167.22 / $167.22	Facility		$56.22	$167.22	$167.22
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.62 / $172.32 / $326.10	Facility		$43.62	$172.32	$326.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $113.44 / $147.88	Professional		$31.84	$113.44	$147.88
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.48 / $59.13 / $89.86	Facility		$22.48	$59.13	$89.86
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $44.74 / $76.28 / $93.77	Professional		$44.74	$76.28	$93.77
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.92 / $78.14 / $363.92	Facility		$38.92	$78.14	$363.92
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.11 / $40.94 / $85.09	Professional		$34.11	$40.94	$85.09
Molina Facility/Professional Professional Modifier Low / Median / High Price $28.93 / $58.40 / $85.00	Professional		$28.93	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $22.48 / $59.13 / $89.86	Facility		$22.48	$59.13	$89.86
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $44.74 / $76.28 / $93.77	Professional		$44.74	$76.28	$93.77
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.14 / $120.26 / $208.77	Professional		$78.14	$120.26	$208.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $43.62 / $152.62 / $363.92	Facility		$43.62	$152.62	$363.92
Quartz Facility/Professional Professional Modifier Low / Median / High Price $31.84 / $43.62 / $393.37	Professional		$31.84	$43.62	$393.37
Security Health Facility/Professional Professional Modifier Low / Median / High Price $78.14 / $78.14 / $78.14	Professional		$78.14	$78.14	$78.14
Security Health Facility/Professional Professional Modifier Low / Median / High Price $62.40 / $78.14 / $78.14	Professional		$62.40	$78.14	$78.14
United Facility/Professional Professional Modifier Low / Median / High Price $27.27 / $38.99 / $74.45	Professional		$27.27	$38.99	$74.45