Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.34 / $39.34 / $39.34	Facility		$39.34	$39.34	$39.34
Aetna Facility/Professional Professional Modifier Low / Median / High Price $37.43 / $39.34 / $75.52	Professional		$37.43	$39.34	$75.52
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $77.98 / $85.78 / $141.91	Facility		$77.98	$85.78	$141.91
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.52 / $72.52 / $95.91	Professional		$72.52	$72.52	$95.91
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.10 / $166.88 / $166.88	Facility		$56.10	$166.88	$166.88
Cigna Facility/Professional Facility Modifier Low / Median / High Price $48.73 / $161.35 / $326.10	Facility		$48.73	$161.35	$326.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $35.57 / $112.97 / $147.58	Professional		$35.57	$112.97	$147.58
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $25.11 / $59.01 / $89.68	Facility		$25.11	$59.01	$89.68
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $44.65 / $77.98 / $93.58	Professional		$44.65	$77.98	$93.58
Medica Facility/Professional Facility Modifier Low / Median / High Price $39.34 / $77.93 / $406.12	Facility		$39.34	$77.93	$406.12
Medica Facility/Professional Professional Modifier Low / Median / High Price $36.26 / $52.10 / $88.03	Professional		$36.26	$52.10	$88.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $34.73 / $58.40 / $85.00	Professional		$34.73	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $25.11 / $59.01 / $89.68	Facility		$25.11	$59.01	$89.68
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $44.65 / $77.98 / $93.58	Professional		$44.65	$77.98	$93.58
Quartz Facility/Professional Professional Modifier Low / Median / High Price $77.98 / $120.03 / $233.86	Professional		$77.98	$120.03	$233.86
Quartz Facility/Professional Facility Modifier Low / Median / High Price $48.73 / $152.30 / $406.12	Facility		$48.73	$152.30	$406.12
Quartz Facility/Professional Professional Modifier Low / Median / High Price $35.57 / $48.73 / $517.77	Professional		$35.57	$48.73	$517.77
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.98 / $77.98 / $77.98	Professional		$77.98	$77.98	$77.98
Security Health Facility/Professional Professional Modifier Low / Median / High Price $77.98 / $77.98 / $77.98	Professional		$77.98	$77.98	$77.98
United Facility/Professional Facility Modifier Low / Median / High Price $39.97 / $39.97 / $39.97	Facility		$39.97	$39.97	$39.97
United Facility/Professional Professional Modifier Low / Median / High Price $31.07 / $51.87 / $69.14	Professional		$31.07	$51.87	$69.14