Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.14 / $29.14 / $29.14	Facility		$29.14	$29.14	$29.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $24.07 / $29.14 / $48.57	Professional		$24.07	$29.14	$48.57
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.77 / $63.55 / $105.14	Facility		$57.77	$63.55	$105.14
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.96 / $53.73 / $71.05	Professional		$49.96	$53.73	$71.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $41.56 / $123.63 / $123.63	Facility		$41.56	$123.63	$123.63
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.36 / $119.13 / $240.73	Facility		$37.36	$119.13	$240.73
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.27 / $83.91 / $109.34	Professional		$27.27	$83.91	$109.34
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.60 / $43.71 / $66.44	Facility		$18.60	$43.71	$66.44
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $57.77 / $77.03	Professional		$33.07	$57.77	$77.03
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.14 / $57.77 / $305.37	Facility		$29.14	$57.77	$305.37
Medica Facility/Professional Professional Modifier Low / Median / High Price $26.86 / $38.60 / $65.22	Professional		$26.86	$38.60	$65.22
Molina Facility/Professional Professional Modifier Low / Median / High Price $25.94 / $58.40 / $85.00	Professional		$25.94	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.60 / $44.58 / $66.44	Facility		$18.60	$44.58	$66.44
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $33.07 / $57.77 / $77.03	Professional		$33.07	$57.77	$77.03
Quartz Facility/Professional Professional Modifier Low / Median / High Price $57.77 / $88.89 / $172.64	Professional		$57.77	$88.89	$172.64
Quartz Facility/Professional Facility Modifier Low / Median / High Price $37.36 / $112.84 / $305.37	Facility		$37.36	$112.84	$305.37
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.27 / $37.36 / $565.29	Professional		$27.27	$37.36	$565.29
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.77 / $57.77 / $57.77	Professional		$57.77	$57.77	$57.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $57.77 / $57.77 / $57.77	Professional		$57.77	$57.77	$57.77
United Facility/Professional Professional Modifier Low / Median / High Price $23.02 / $38.42 / $51.22	Professional		$23.02	$38.42	$51.22