Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $37.29 / $37.29 / $37.29	Facility		$37.29	$37.29	$37.29
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.52 / $37.29 / $65.62	Professional		$32.52	$37.29	$65.62
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.93 / $81.31 / $134.55	Facility		$73.93	$81.31	$134.55
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $66.53 / $68.75 / $90.93	Professional		$66.53	$68.75	$90.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $53.19 / $158.21 / $158.21	Facility		$53.19	$158.21	$158.21
Cigna Facility/Professional Facility Modifier Low / Median / High Price $37.25 / $152.91 / $307.89	Facility		$37.25	$152.91	$307.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $27.19 / $107.34 / $139.93	Professional		$27.19	$107.34	$139.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $18.86 / $55.95 / $85.02	Facility		$18.86	$55.95	$85.02
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $58.54 / $88.72	Professional		$42.34	$58.54	$88.72
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.64 / $73.93 / $304.39	Facility		$32.64	$73.93	$304.39
Medica Facility/Professional Professional Modifier Low / Median / High Price $29.60 / $44.00 / $80.50	Professional		$29.60	$44.00	$80.50
Molina Facility/Professional Professional Modifier Low / Median / High Price $24.80 / $58.40 / $85.00	Professional		$24.80	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $18.86 / $55.95 / $85.02	Facility		$18.86	$55.95	$85.02
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $42.34 / $58.54 / $88.72	Professional		$42.34	$58.54	$88.72
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.93 / $111.64 / $175.65	Professional		$73.93	$111.64	$175.65
Quartz Facility/Professional Facility Modifier Low / Median / High Price $37.25 / $144.40 / $304.39	Facility		$37.25	$144.40	$304.39
Quartz Facility/Professional Professional Modifier Low / Median / High Price $27.19 / $37.25 / $325.36	Professional		$27.19	$37.25	$325.36
Security Health Facility/Professional Professional Modifier Low / Median / High Price $73.93 / $73.93 / $73.93	Professional		$73.93	$73.93	$73.93
Security Health Facility/Professional Professional Modifier Low / Median / High Price $59.04 / $73.93 / $73.93	Professional		$59.04	$73.93	$73.93
United Facility/Professional Professional Modifier Low / Median / High Price $24.59 / $38.94 / $63.41	Professional		$24.59	$38.94	$63.41