Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $35.04 / $35.04 / $35.04	Facility		$35.04	$35.04	$35.04
Aetna Facility/Professional Professional Modifier Low / Median / High Price $25.55 / $35.04 / $58.19	Professional		$25.55	$35.04	$58.19
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $69.48 / $76.43 / $126.45	Facility		$69.48	$76.43	$126.45
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $62.53 / $64.62 / $85.46	Professional		$62.53	$64.62	$85.46
CareSource Facility/Professional Facility Modifier Low / Median / High Price $49.99 / $148.69 / $148.69	Facility		$49.99	$148.69	$148.69
Cigna Facility/Professional Facility Modifier Low / Median / High Price $44.94 / $143.53 / $289.70	Facility		$44.94	$143.53	$289.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $32.81 / $100.78 / $131.49	Professional		$32.81	$100.78	$131.49
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.75 / $52.58 / $79.90	Facility		$19.75	$52.58	$79.90
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $39.77 / $69.48 / $83.38	Professional		$39.77	$69.48	$83.38
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.18 / $69.48 / $328.96	Facility		$34.18	$69.48	$328.96
Medica Facility/Professional Professional Modifier Low / Median / High Price $31.29 / $46.08 / $75.65	Professional		$31.29	$46.08	$75.65
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.25 / $58.40 / $85.00	Professional		$30.25	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.75 / $52.58 / $79.90	Facility		$19.75	$52.58	$79.90
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $39.77 / $69.48 / $83.38	Professional		$39.77	$69.48	$83.38
Quartz Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $106.92 / $183.68	Professional		$69.48	$106.92	$183.68
Quartz Facility/Professional Facility Modifier Low / Median / High Price $44.94 / $135.69 / $328.96	Facility		$44.94	$135.69	$328.96
Quartz Facility/Professional Professional Modifier Low / Median / High Price $32.81 / $44.94 / $392.45	Professional		$32.81	$44.94	$392.45
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $69.48 / $69.48	Professional		$69.48	$69.48	$69.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $69.48 / $69.48 / $69.48	Professional		$69.48	$69.48	$69.48
United Facility/Professional Facility Modifier Low / Median / High Price $37.24 / $37.24 / $37.24	Facility		$37.24	$37.24	$37.24
United Facility/Professional Professional Modifier Low / Median / High Price $23.95 / $40.78 / $59.58	Professional		$23.95	$40.78	$59.58