Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.27 / $39.27 / $39.27	Facility		$39.27	$39.27	$39.27
Aetna Facility/Professional Professional Modifier Low / Median / High Price $35.51 / $39.27 / $71.64	Professional		$35.51	$39.27	$71.64
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.84 / $85.64 / $141.69	Facility		$77.84	$85.64	$141.69
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.33 / $72.40 / $95.75	Professional		$67.33	$72.40	$95.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $166.60 / $166.60	Facility		$56.00	$166.60	$166.60
Cigna Facility/Professional Facility Modifier Low / Median / High Price $50.36 / $161.35 / $324.70	Facility		$50.36	$161.35	$324.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $36.76 / $112.97 / $147.35	Professional		$36.76	$112.97	$147.35
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.07 / $58.91 / $89.53	Facility		$25.07	$58.91	$89.53
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $44.58 / $77.84 / $93.42	Professional		$44.58	$77.84	$93.42
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.27 / $77.84 / $404.35	Facility		$39.27	$77.84	$404.35
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.20 / $52.02 / $87.89	Professional		$36.20	$52.02	$87.89
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 $25.07 / $58.91 / $89.53	Facility		$25.07	$58.91	$89.53
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $44.58 / $77.84 / $93.42	Professional		$44.58	$77.84	$93.42
Quartz Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $119.81 / $232.86	Professional		$77.84	$119.81	$232.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $50.36 / $152.06 / $404.35	Facility		$50.36	$152.06	$404.35
Quartz Facility/Professional Professional Modifier Low / Median / High Price $36.76 / $50.36 / $490.30	Professional		$36.76	$50.36	$490.30
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $77.84 / $77.84	Professional		$77.84	$77.84	$77.84
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.84 / $77.84 / $77.84	Professional		$77.84	$77.84	$77.84
United Facility/Professional Professional Modifier Low / Median / High Price $31.02 / $46.71 / $69.02	Professional		$31.02	$46.71	$69.02