Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $27.88 / $27.88 / $27.88	Facility		$27.88	$27.88	$27.88
Aetna Facility/Professional Professional Modifier Low / Median / High Price $23.03 / $27.88 / $46.46	Professional		$23.03	$27.88	$46.46
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $55.27 / $60.80 / $100.59	Facility		$55.27	$60.80	$100.59
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $49.74 / $51.40 / $67.98	Professional		$49.74	$51.40	$67.98
CareSource Facility/Professional Facility Modifier Low / Median / High Price $39.77 / $118.28 / $118.28	Facility		$39.77	$118.28	$118.28
Cigna Facility/Professional Facility Modifier Low / Median / High Price $34.54 / $114.44 / $230.93	Facility		$34.54	$114.44	$230.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $25.21 / $80.16 / $104.61	Professional		$25.21	$80.16	$104.61
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $17.80 / $41.82 / $63.56	Facility		$17.80	$41.82	$63.56
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $55.27 / $66.31	Professional		$31.65	$55.27	$66.31
Medica Facility/Professional Facility Modifier Low / Median / High Price $27.88 / $55.27 / $279.95	Facility		$27.88	$55.27	$279.95
Medica Facility/Professional Professional Modifier Low / Median / High Price $25.70 / $36.94 / $60.80	Professional		$25.70	$36.94	$60.80
Molina Facility/Professional Professional Modifier Low / Median / High Price $30.59 / $58.40 / $85.00	Professional		$30.59	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $17.80 / $42.66 / $63.56	Facility		$17.80	$42.66	$63.56
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $31.65 / $55.27 / $66.31	Professional		$31.65	$55.27	$66.31
Quartz Facility/Professional Professional Modifier Low / Median / High Price $55.27 / $85.09 / $165.61	Professional		$55.27	$85.09	$165.61
Quartz Facility/Professional Facility Modifier Low / Median / High Price $34.54 / $107.96 / $279.95	Facility		$34.54	$107.96	$279.95
Quartz Facility/Professional Professional Modifier Low / Median / High Price $25.21 / $34.54 / $364.82	Professional		$25.21	$34.54	$364.82
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.27 / $55.27 / $55.27	Professional		$55.27	$55.27	$55.27
Security Health Facility/Professional Professional Modifier Low / Median / High Price $55.27 / $55.27 / $55.27	Professional		$55.27	$55.27	$55.27
United Facility/Professional Professional Modifier Low / Median / High Price $22.02 / $35.22 / $49.01	Professional		$22.02	$35.22	$49.01