Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $29.89 / $29.89 / $29.89	Facility		$29.89	$29.89	$29.89
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.89 / $32.42 / $65.41	Professional		$29.89	$32.42	$65.41
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $59.25 / $65.18 / $107.84	Facility		$59.25	$65.18	$107.84
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $55.10 / $55.10 / $72.87	Professional		$55.10	$55.10	$72.87
CareSource Facility/Professional Facility Modifier Low / Median / High Price $42.63 / $126.80 / $126.80	Facility		$42.63	$126.80	$126.80
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.03 / $122.89 / $247.72	Facility		$37.03	$122.89	$247.72
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.03 / $85.78 / $112.14	Professional		$27.03	$85.78	$112.14
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $19.07 / $44.84 / $68.14	Facility		$19.07	$44.84	$68.14
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $33.93 / $59.25 / $79.00	Professional		$33.93	$59.25	$79.00
Medica Facility/Professional Facility Modifier Low / Median / High Price $29.89 / $59.25 / $321.47	Facility		$29.89	$59.25	$321.47
Medica Facility/Professional Professional Modifier Low / Median / High Price $27.55 / $39.59 / $66.91	Professional		$27.55	$39.59	$66.91
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.79 / $58.40 / $85.00	Professional		$32.79	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $19.07 / $45.73 / $68.14	Facility		$19.07	$45.73	$68.14
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $33.93 / $59.25 / $79.00	Professional		$33.93	$59.25	$79.00
Quartz Facility/Professional Professional Modifier Low / Median / High Price $59.25 / $91.19 / $177.65	Professional		$59.25	$91.19	$177.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $37.03 / $115.72 / $321.47	Facility		$37.03	$115.72	$321.47
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.03 / $37.03 / $398.48	Professional		$27.03	$37.03	$398.48
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.25 / $59.25 / $59.25	Professional		$59.25	$59.25	$59.25
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.25 / $59.25 / $59.25	Professional		$59.25	$59.25	$59.25
United Facility/Professional Professional Modifier Low / Median / High Price $23.61 / $35.54 / $50.82	Professional		$23.61	$35.54	$50.82