Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $48.19 / $48.19 / $48.19	Facility		$48.19	$48.19	$48.19
Aetna Facility/Professional Professional Modifier Low / Median / High Price $45.37 / $48.19 / $86.17	Professional		$45.37	$48.19	$86.17
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $95.54 / $105.09 / $173.88	Facility		$95.54	$105.09	$173.88
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $85.98 / $88.85 / $117.51	Professional		$85.98	$88.85	$117.51
CareSource Facility/Professional Facility Modifier Low / Median / High Price $68.73 / $204.46 / $204.46	Facility		$68.73	$204.46	$204.46
Cigna Facility/Professional Facility Modifier Low / Median / High Price $61.81 / $197.92 / $398.88	Facility		$61.81	$197.92	$398.88
Cigna Facility/Professional Professional Modifier Low / Median / High Price $45.12 / $138.28 / $180.81	Professional		$45.12	$138.28	$180.81
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $30.77 / $72.29 / $109.87	Facility		$30.77	$72.29	$109.87
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $54.70 / $95.54 / $127.38	Professional		$54.70	$95.54	$127.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $48.19 / $100.32 / $510.12	Facility		$48.19	$100.32	$510.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $43.28 / $55.61 / $107.86	Professional		$43.28	$55.61	$107.86
Molina Facility/Professional Professional Modifier Low / Median / High Price $38.91 / $55.00 / $85.00	Professional		$38.91	$55.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $30.77 / $72.29 / $109.87	Facility		$30.77	$72.29	$109.87
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $54.70 / $95.54 / $127.38	Professional		$54.70	$95.54	$127.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $147.03 / $286.05	Professional		$95.54	$147.03	$286.05
Quartz Facility/Professional Facility Modifier Low / Median / High Price $61.81 / $186.60 / $510.12	Facility		$61.81	$186.60	$510.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $45.12 / $61.81 / $677.70	Professional		$45.12	$61.81	$677.70
Security Health Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $95.54 / $95.54	Professional		$95.54	$95.54	$95.54
Security Health Facility/Professional Professional Modifier Low / Median / High Price $95.54 / $95.54 / $95.54	Professional		$95.54	$95.54	$95.54
United Facility/Professional Professional Modifier Low / Median / High Price $39.72 / $50.63 / $95.54	Professional		$39.72	$50.63	$95.54