Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $38.45 / $38.45 / $38.45	Facility		$38.45	$38.45	$38.45
Aetna Facility/Professional Professional Modifier Low / Median / High Price $31.91 / $38.45 / $64.39	Professional		$31.91	$38.45	$64.39
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $76.22 / $83.84 / $138.72	Facility		$76.22	$83.84	$138.72
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $65.91 / $70.88 / $93.75	Professional		$65.91	$70.88	$93.75
CareSource Facility/Professional Facility Modifier Low / Median / High Price $54.82 / $163.11 / $163.11	Facility		$54.82	$163.11	$163.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $43.76 / $168.31 / $317.70	Facility		$43.76	$168.31	$317.70
Cigna Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $126.94 / $144.25	Professional		$37.20	$126.94	$144.25
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $21.92 / $57.68 / $87.65	Facility		$21.92	$57.68	$87.65
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $43.63 / $74.34 / $91.46	Professional		$43.63	$74.34	$91.46
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.95 / $76.22 / $354.84	Facility		$37.95	$76.22	$354.84
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $50.92 / $82.99	Professional		$34.79	$50.92	$82.99
Molina Facility/Professional Professional Modifier Low / Median / High Price $50.00 / $65.00 / $85.00	Professional		$50.00	$65.00	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $21.92 / $57.68 / $87.65	Facility		$21.92	$57.68	$87.65
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $43.63 / $74.34 / $91.46	Professional		$43.63	$74.34	$91.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $76.22 / $117.28 / $203.75	Professional		$76.22	$117.28	$203.75
Quartz Facility/Professional Facility Modifier Low / Median / High Price $43.76 / $148.86 / $354.84	Facility		$43.76	$148.86	$354.84
Quartz Facility/Professional Professional Modifier Low / Median / High Price $37.20 / $43.76 / $383.76	Professional		$37.20	$43.76	$383.76
Security Health Facility/Professional Professional Modifier Low / Median / High Price $76.22 / $76.22 / $76.22	Professional		$76.22	$76.22	$76.22
Security Health Facility/Professional Professional Modifier Low / Median / High Price $76.22 / $76.22 / $76.22	Professional		$76.22	$76.22	$76.22
United Facility/Professional Professional Modifier Low / Median / High Price $28.30 / $45.73 / $67.56	Professional		$28.30	$45.73	$67.56