Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $39.39 / $39.39 / $39.39	Facility		$39.39	$39.39	$39.39
Aetna Facility/Professional Professional Modifier Low / Median / High Price $32.70 / $39.39 / $65.98	Professional		$32.70	$39.39	$65.98
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $78.09 / $85.90 / $142.12	Facility		$78.09	$85.90	$142.12
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $72.62 / $78.09 / $108.93	Professional		$72.62	$78.09	$108.93
CareSource Facility/Professional Facility Modifier Low / Median / High Price $56.18 / $167.11 / $167.11	Facility		$56.18	$167.11	$167.11
Cigna Facility/Professional Facility Modifier Low / Median / High Price $62.01 / $172.32 / $326.10	Facility		$62.01	$172.32	$326.10
Cigna Facility/Professional Professional Modifier Low / Median / High Price $52.71 / $114.78 / $147.79	Professional		$52.71	$114.78	$147.79
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $22.47 / $59.09 / $89.80	Facility		$22.47	$59.09	$89.80
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $44.71 / $76.23 / $93.71	Professional		$44.71	$76.23	$93.71
Medica Facility/Professional Facility Modifier Low / Median / High Price $38.90 / $78.09 / $335.46	Facility		$38.90	$78.09	$335.46
Medica Facility/Professional Professional Modifier Low / Median / High Price $35.67 / $52.18 / $85.03	Professional		$35.67	$52.18	$85.03
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.46 / $58.40 / $85.00	Professional		$43.46	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $22.47 / $59.09 / $89.80	Facility		$22.47	$59.09	$89.80
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $44.71 / $76.23 / $93.71	Professional		$44.71	$76.23	$93.71
Quartz Facility/Professional Professional Modifier Low / Median / High Price $78.09 / $120.17 / $208.77	Professional		$78.09	$120.17	$208.77
Quartz Facility/Professional Facility Modifier Low / Median / High Price $62.01 / $152.52 / $335.46	Facility		$62.01	$152.52	$335.46
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.71 / $62.01 / $394.02	Professional		$52.71	$62.01	$394.02
Security Health Facility/Professional Professional Modifier Low / Median / High Price $78.09 / $78.09 / $78.09	Professional		$78.09	$78.09	$78.09
Security Health Facility/Professional Professional Modifier Low / Median / High Price $78.09 / $78.09 / $78.09	Professional		$78.09	$78.09	$78.09
United Facility/Professional Facility Modifier Low / Median / High Price $46.00 / $52.39 / $53.64	Facility		$46.00	$52.39	$53.64
United Facility/Professional Professional Modifier Low / Median / High Price $31.11 / $49.78 / $66.97	Professional		$31.11	$49.78	$66.97