Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $42.81 / $42.81 / $42.81	Facility		$42.81	$42.81	$42.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $33.96 / $42.81 / $61.76	Professional		$33.96	$42.81	$61.76
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $73.73 / $73.73 / $121.65	Facility		$73.73	$73.73	$121.65
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $68.56 / $73.73 / $84.05	Professional		$68.56	$73.73	$84.05
CareSource Facility/Professional Facility Modifier Low / Median / High Price $73.73 / $157.78 / $157.78	Facility		$73.73	$157.78	$157.78
Cigna Facility/Professional Facility Modifier Low / Median / High Price $198.25 / $231.67 / $307.89	Facility		$198.25	$231.67	$307.89
Cigna Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $106.88 / $139.54	Professional		$30.08	$106.88	$139.54
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $42.30 / $60.76 / $73.73	Facility		$42.30	$60.76	$73.73
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $53.98 / $53.98 / $73.73	Professional		$53.98	$53.98	$73.73
Medica Facility/Professional Facility Modifier Low / Median / High Price $42.30 / $60.76 / $77.42	Facility		$42.30	$60.76	$77.42
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.00 / $41.69 / $182.30	Professional		$34.00	$41.69	$182.30
Molina Facility/Professional Professional Modifier Low / Median / High Price $42.81 / $58.40 / $85.00	Professional		$42.81	$58.40	$85.00
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $42.30 / $60.76 / $73.73	Facility		$42.30	$60.76	$73.73
Prevea360 Facility/Professional Professional Modifier Low / Median / High Price $53.98 / $53.98 / $73.73	Professional		$53.98	$53.98	$73.73
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $110.60 / $194.00	Professional		$73.73	$110.60	$194.00
Quartz Facility/Professional Facility Modifier Low / Median / High Price $144.00 / $149.66 / $345.06	Facility		$144.00	$149.66	$345.06
Quartz Facility/Professional Professional Modifier Low / Median / High Price $30.08 / $324.00 / $648.41	Professional		$30.08	$324.00	$648.41
Security Health Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $73.73 / $73.73	Professional		$73.73	$73.73	$73.73
Security Health Facility/Professional Professional Modifier Low / Median / High Price $73.73 / $73.73 / $73.73	Professional		$73.73	$73.73	$73.73
United Facility/Professional Professional Modifier Low / Median / High Price $26.06 / $36.79 / $61.31	Professional		$26.06	$36.79	$61.31